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1780324038
LOGAN REX TAYSOM
GOODYEAR, AZ
NPI
1780324038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-04-01
Last Update Date
2022-04-01
Business Address
DR. LOGAN REX TAYSOM MD, MS
13677 W MCDOWELL RD
GOODYEAR, AZ 85395-2635
Phone number: 480-254-8690
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Mailing Address
DR. LOGAN REX TAYSOM MD, MS
1236 S MARGO DR
TEMPE, AZ 85281-5352
Phone number: 480-254-8690
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