LOGAN MACKENZIE WILLIS

PETERSBURG, WV
NPI1295341675
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician, Personal Care Attendant
Enumeration Date2020-09-21
Last Update Date2020-09-21
Business Address
LOGAN MACKENZIE WILLIS
216 CLIFFTOP DR APT 86
PETERSBURG, WV 26847-8893
Phone number: 304-668-2282
Mailing Address
LOGAN MACKENZIE WILLIS
277 HAWK RIDGE RD
PETERSBURG, WV 26847-7650
Phone number:
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