JACOB T LOGAN

LEBANON, OR
NPI1932812583
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: MI  5151017276)
Enumeration Date2022-12-28
Last Update Date2025-06-27
Business Address
JACOB T LOGAN
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
Mailing Address
JACOB T LOGAN
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
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