Most Relevant Information
Provider Data
| NPI Number: | 1003679648 |
| Provider Name: | THOMAS LOGAN POWELL |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/05/2024 |
| Last Updated: | 02/05/2024 |
Provider Practice Location
2945 LAYFAIR DR APT 321
FLOWOOD
MS
392329758
Practice Location Phone/Fax
| Phone: | 6019344578 |
| Fax: |
Provider Mailing Location
2945 LAYFAIR DR APT 321
FLOWOOD
MS
392329758
Provider Mailing Phone/Fax
| Phone: | 6019344578 |
| Fax: |