Individual
MRS. DENISE LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS RD LD
Contact information
Practice address
3811 WALNUT ST, LORIS, SC 29569
(843) 756-4027
(843) 756-4039
Mailing address
3811 WALNUT ST, LORIS HEALTH DEPT, LORIS, SC 29569
(843) 756-4027
(843) 756-4039
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
329
SC
Other
Enumeration date
07/02/2014
Last updated
07/02/2014
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