Individual
LISA MARIE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
825 S MAIN ST., TONOPAH, NV 89049
(775) 982-8255
(775) 982-3900
Mailing address
850 HARVARD WAY # T5, RENO, NV 89502-2055
(775) 982-5262
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1023
NV
Other
Enumeration date
11/10/2006
Last updated
08/23/2018
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