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Individual

LOGAN BECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1805 HENNEPIN AVE N, GLENCOE, MN 55336-1416
(507) 525-3881
Mailing address
1805 HENNEPIN AVE N, GLENCOE, MN 55336-1416

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2106
MN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/11/2017
Last updated
09/15/2017
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