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1578180006
LOGAN MOCK
FAYETTEVILLE, NC
NPI
1578180006
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-06-30
Last Update Date
2021-02-12
Business Address
LOGAN MOCK PA
1638 OWEN DR
FAYETTEVILLE, NC 28304-3424
Phone number: 843-726-1470
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Mailing Address
LOGAN MOCK PA
1638 OWEN DR
FAYETTEVILLE, NC 28304-3424
Phone number:
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