Individual
AMANDA LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2121 NORTH AVE, GRAND JUNCTION, CO 81501-6428
(970) 263-5077
Mailing address
340 BELFORD AVE, GRAND JUNCTION, CO 81501-2428
(970) 209-2977
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
0330373
CO
Other
Enumeration date
09/12/2014
Last updated
09/12/2014
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