LOGAN MCHAEL SOUTHWELL

SHAWNEE, OK
NPI1851146229
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
Enumeration Date2024-04-19
Last Update Date2024-04-19
Business Address
Mr. LOGAN MCHAEL SOUTHWELL
1601 GORDON COOPER DR
SHAWNEE, OK 74801-9002
Phone number: 405-878-3854
Mailing Address
Mr. LOGAN MCHAEL SOUTHWELL
1601 GORDON COOPER DR
SHAWNEE, OK 74801-9002
Phone number: 405-878-3854