Individual
DR. LOGAN RUSSELL HENDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
790 CHURCH ST NE STE 210, MARIETTA, GA 30060-8950
(770) 424-3131
Mailing address
790 CHURCH ST NE STE 210, MARIETTA, GA 30060-8950
(770) 424-3131
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH028870
GA
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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