Individual
CHARLES AUGUSTUS LOGAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
625 PINEY FOREST RD STE 307B, DANVILLE, VA 24540-2869
(434) 797-1292
Mailing address
625 PINEY FOREST RD STE 307B, DANVILLE, VA 24540-2869
(434) 797-1292
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
11/11/2019
Last updated
11/11/2019
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