LOGAN LAUDERDALE WALLACE

JOHNSON CITY, TN
NPI1811567100
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-06-29
Last Update Date2025-06-22
Business Address
Dr. LOGAN LAUDERDALE WALLACE MD
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604-6035
Phone number: 423-431-6111
Mailing Address
Dr. LOGAN LAUDERDALE WALLACE MD
400 N STATE OF FRANKLIN RD
JOHNSON CITY, TN 37604-6035
Phone number: