Organization
SANCTUARY INTEGRATIVE MEDICINE PC
Active
Organization
SANCTUARY INTEGRATIVE MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK E LOGAN MD (PROVIDER)
(802) 775-7848
Entity
Organization
Contact information
Practice address
90 MAHONEY AVE, RUTLAND, VT 05701-4836
(802) 775-7848
(802) 774-5145
Mailing address
90 MAHONEY AVE, RUTLAND, VT 05701-4836
(802) 775-7848
(802) 774-5145
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
0420006819
VT
Other
Enumeration date
10/23/2008
Last updated
06/18/2010
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