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1699059659
SAMUEL LOGAN
UKIAH, CA
NPI
1699059659
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2011-10-07
Last Update Date
2011-10-07
Business Address
-- SAMUEL LOGAN
350 E GOBBI ST
UKIAH, CA 95482-5511
Phone number: 707-472-2922
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Mailing Address
-- SAMUEL LOGAN
6431 BLACK BART TRL
REDWOOD VALLEY, CA 95470-6248
Phone number: 707-467-9192
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