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1851146229
LOGAN MCHAEL SOUTHWELL
SHAWNEE, OK
NPI
1851146229
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2024-04-19
Last Update Date
2024-04-19
Business Address
Mr. LOGAN MCHAEL SOUTHWELL
1601 GORDON COOPER DR
SHAWNEE, OK 74801-9002
Phone number: 405-878-3854
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Mailing Address
Mr. LOGAN MCHAEL SOUTHWELL
1601 GORDON COOPER DR
SHAWNEE, OK 74801-9002
Phone number: 405-878-3854
Copy
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