Individual
LOGAN M CANTERBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2201 LEXINGTON AVE, ASHLAND, KY 41101-2843
(606) 408-4000
Mailing address
3944 8TH STREET RD, HUNTINGTON, WV 25701-9435
(304) 544-4170
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4023022
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2022
Last updated
07/02/2024
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