Individual
KENTON R. LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
5435 HIGHWAY 1, MARKSVILLE, LA 71351
(318) 253-8846
(318) 253-8875
Mailing address
5435 HIGHWAY 1, MARKSVILLE, LA 71351
(318) 253-8846
(318) 253-8875
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
03521
LA
Other
Enumeration date
10/18/2006
Last updated
07/08/2007
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