Individual
CARLOTTA D LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-2137
(928) 669-3131
Mailing address
230 E OASIS ST, BLYTHE, CA 92225-1282
(760) 921-3233
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
LPN
CA
Other
Enumeration date
08/31/2011
Last updated
08/31/2011
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