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Individual
MR. MARSHALL LOGAN JR.
Active
Individual
MR. MARSHALL LOGAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
214743
GA
Other
Enumeration date
02/11/2019
Last updated
12/07/2020
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