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1932812583
JACOB T LOGAN
LEBANON, OR
NPI
1932812583
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-12-28
Last Update Date
2023-01-02
Business Address
JACOB T LOGAN
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
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Mailing Address
JACOB T LOGAN
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
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