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1801301205
LOGAN JOHNSON
OMAHA, NE
NPI
1801301205
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: NE 937)
Enumeration Date
2017-12-06
Last Update Date
2018-09-05
Business Address
LOGAN JOHNSON
8803 WEBSTER PLZ
OMAHA, NE 68114
Phone number: 308-325-5088
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Mailing Address
LOGAN JOHNSON
8803 WEBSTER PLZ
OMAHA, NE 68114-2832
Phone number: 308-325-5088
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