Individual
LOGAN TENNANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
37 GRANDE MEADOWS DR, BRIDGEPORT, WV 26330-9035
(304) 592-3538
Mailing address
37 GRANDE MEADOWS DR, BRIDGEPORT, WV 26330-9035
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002682
WV
Other
Enumeration date
05/02/2024
Last updated
05/02/2024
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