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Individual

MS. MARY ELIZABETH LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1231
Mailing address
14870 WARD ST, DETROIT, MI 48227-3665
(313) 931-1002

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
290101040761728
MI

Other

Enumeration date
05/03/2007
Last updated
07/08/2007
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