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Individual

MS. CORI LYN LOGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1540 FLORIDA AVE STE 100, MODESTO, CA 95350
(209) 544-3236
(209) 577-8125
Mailing address
1540 FLORIDA AVE STE 100, MODESTO, CA 95350
(209) 544-3236
(209) 577-8125

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
694048
CA

Other

Enumeration date
01/08/2007
Last updated
07/08/2007
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