| NPI | 1932139235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C LOGAN Physician Owner 270-691-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology |
| 207YS0123X Otolaryngology, Facial Plastic Surgery | |
| 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2019-02-25 |