Individual
LOGAN DAVID WELCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
588 LONGMEADOW ST, LONGMEADOW, MA 01106-2292
(413) 565-1000
Mailing address
21 HANSEN DR, VERNON, CT 06066-5914
(860) 597-9990
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6625
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/05/2022
Last updated
07/17/2024
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