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Individual

KELLY J. LOGAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
601 E 63RD ST STE 210, KANSAS CITY, MO 64110-3303
(816) 569-5475
(816) 569-5482
Mailing address
601 E 63RD ST STE 210, KANSAS CITY, MO 64110-3303
(816) 569-5475
(816) 569-5482

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
0533193
KS
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2010035953
MO
208100000X
Physical Medicine & Rehabilitation Physician
48544
WI

Other

Enumeration date
05/09/2006
Last updated
04/20/2021
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