Individual
YEN LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 490-8400
Mailing address
14139 POTOMAC MILLS RD, WOODBRIDGE, VA 22192-4644
(703) 490-8400
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
0202205698
VA
Other
Enumeration date
10/01/2016
Last updated
10/01/2016
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