Individual
JONATHAN LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
165 ROCKY STEP RD, SCOTT DEPOT, WV 25560-9201
(304) 741-2896
Mailing address
165 ROCKY STEP RD, SCOTT DEPOT, WV 25560-9201
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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