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1730711029
LOGAN ELLIOTT
KINGSPORT, TN
NPI
1730711029
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: TN 27109)
Enumeration Date
2020-02-05
Last Update Date
2020-02-05
Business Address
LOGAN ELLIOTT NP-C
1330 RIVERBEND DR APT 104
KINGSPORT, TN 37664-4096
Phone number: 276-690-6674
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Mailing Address
LOGAN ELLIOTT NP-C
1330 RIVERBEND DR APT 104
KINGSPORT, TN 37664-4096
Phone number:
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