Individual
DR. LOGAN DAKOTA LOCKRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
9995 COBB RD, DELTON, MI 49046-9525
(269) 250-0822
Mailing address
9995 COBB RD, DELTON, MI 49046-9525
(269) 250-0822
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302413371
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302413371
PHARMACY LICENSE
MI
Enumeration date
05/26/2021
Last updated
05/26/2021
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