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Individual
LOGAN LEDBETTER
Active
Individual
LOGAN LEDBETTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD, CNSC
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86006556
CA
363A00000X
Physician Assistant
Primary
1178331
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457883068
—
CA
Enumeration date
04/02/2017
Last updated
03/05/2025
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