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1215614599
WYATT M LOGAN
FULLERTON, CA
NPI
1215614599
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-06-29
Last Update Date
2023-06-29
Business Address
WYATT M LOGAN
1630 W GAGE AVE
FULLERTON, CA 92833-4526
Phone number: 714-388-4499
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Mailing Address
WYATT M LOGAN
1630 W GAGE AVE
FULLERTON, CA 92833-4526
Phone number: 714-388-4499
Copy
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