Individual
LOGAN JAMES GYLTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0002
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
122818
MN
1835P2201X
Ambulatory Care Pharmacist
122818
MN
Other
Enumeration date
07/05/2018
Last updated
05/08/2019
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