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1245886563
LOGAN BLACKMON
BOWLING GREEN, KY
NPI
1245886563
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2019-08-13
Last Update Date
2019-08-13
Business Address
LOGAN BLACKMON
1711 DESTINY LN STE 107
BOWLING GREEN, KY 42104-1067
Phone number: 270-702-2464
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Mailing Address
LOGAN BLACKMON
1321 MURFREESBORO PIKE STE 702
NASHVILLE, TN 37217-2679
Phone number: 615-695-2277
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