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Individual

LOGAN CHARLES MCCOOL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1401 CAMPUS DR, CLIVE, IA 50325-6500
(515) 381-6519
Mailing address
1776 WOODSTEAD CT STE 208, THE WOODLANDS, TX 77380-1480
(281) 724-3050

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
85067
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
DO-06305
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0142384
IA
Enumeration date
04/29/2015
Last updated
12/01/2025
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