Organization
LOGAN FOOT & ANKLE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMIE L HALL-JASPER DPM (OWNER)
(216) 246-7958
Entity
Organization
Contact information
Practice address
100 MAIN AVE, LOGAN, WV 25601-3323
(304) 896-5012
(304) 896-5013
Mailing address
PO BOX 186, LOGAN, WV 25601-0186
(304) 896-5012
(304) 896-5013
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
10421
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810026851
—
WV
Enumeration date
11/24/2014
Last updated
03/19/2015
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