NPI Registry.org

Logan Dameron

NPI Registration Record

Provider / OrganizationNPIDate Certified
LOGAN DAMERON10832607642021-01-10
Entity TypeIndividual
Provider Name Logan Dameron
Practice Office Address901 MERCHANT DR
KNOXVILLE, TN US
Practice Office Telephone8656872277
Mailing Address5835 WALL FLOWER LN
KNOXVILLE, TN 379241599 US
Business Telephone4233602383
Offices / Locations
AddressCity / StatePhone / Fax
4156 Walker Blvd Knoxville, TN 379172217 4233602383
HPT Codes
CodeLicense NoState
363L00000X PRIMARYAPN0000026282 TN
OPI Codes

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