Individual
MARK EDWARD LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3823 MAIN ST, CHINCOTEAGUE, VA 23336-1857
(757) 336-2844
(757) 336-2811
Mailing address
3823 MAIN ST, CHINCOTEAGUE, VA 23336-1857
(757) 336-2844
(757) 336-2811
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
09/24/2021
Last updated
09/24/2021
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