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1114574142
LOGAN JERALD DEWHITT
FAYETTEVILLE, AR
NPI
1114574142
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: AR PT4706)
Enumeration Date
2019-08-23
Last Update Date
2019-08-23
Business Address
LOGAN JERALD DEWHITT DPT
3317 N WIMBERLY DR FL 2
FAYETTEVILLE, AR 72703-4056
Phone number: 795-873-1174
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Mailing Address
LOGAN JERALD DEWHITT DPT
3317 N WIMBERLY DR FL 2
FAYETTEVILLE, AR 72703-4056
Phone number: 795-873-1174
Copy
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