Individual
DR. LOGAN MICHAEL PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1360 E VENICE AVE, VENICE, FL 34285-9066
(941) 488-2020
Mailing address
1360 E VENICE AVE, VENICE, FL 34285-9066
(941) 488-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2782
AR
Other
Enumeration date
07/23/2018
Last updated
02/24/2022
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