Individual
MR. LOGAN SEBASTIAN CONGDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 BALL AVE NE BLDG B, GRAND RAPIDS, MI 49505-5904
(616) 451-3001
Mailing address
1059 SAN JUAN DR SE, EAST GRAND RAPIDS, MI 49506-3452
(616) 802-4890
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/01/2022
Last updated
05/01/2022
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