# SANCTUARY INTEGRATIVE MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568615441
- **Authorized official:** MARK E LOGAN MD (PROVIDER)
- **Authorized official phone:** (802) 775-7848

## Contact information

- **Practice address:** 90 MAHONEY AVE, RUTLAND, VT 05701-4836
- **Practice address phone:** (802) 775-7848
- **Practice address fax:** (802) 774-5145
- **Mailing address:** 90 MAHONEY AVE, RUTLAND, VT 05701-4836
- **Mailing address phone:** (802) 775-7848
- **Mailing address fax:** (802) 774-5145

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | 0420006819 | VT | Yes |

## Other

- **Enumeration date:** 10/23/2008
- **Last updated:** 06/18/2010