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1053190975
KENDRICK WAYNE LOGAN
COLTON, CA
NPI
1053190975
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-09-28
Last Update Date
2023-09-28
Business Address
KENDRICK WAYNE LOGAN
1330 E COOLEY DR
COLTON, CA 92324-3905
Phone number: 909-580-3734
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Mailing Address
KENDRICK WAYNE LOGAN
1330 E COOLEY DR
COLTON, CA 92324-3905
Phone number: 909-580-3734
Copy
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