Individual
MIA LOGSDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6192
(215) 316-5151
Mailing address
2116 ASHLEY RD, NEWTOWN, PA 18940-3735
(215) 901-3799
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
PA
Other
Enumeration date
06/21/2022
Last updated
06/21/2022
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