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Individual

LOGAN DAVID DRISCOLL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
12499 UNIVERSITY AVE STE 210, CLIVE, IA 50325-8288
(515) 440-2676
Mailing address
1005 NE CYPRESS CIR, GRIMES, IA 50111-1241
(515) 991-6227

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
01/09/2020
Last updated
08/23/2021
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