Individual
LOGAN EDWARD LEAFERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
701 S HEALTH PKWY, THREE RIVERS, MI 49093-8352
(269) 278-1145
Mailing address
5904 DAKOTA AVE, PORTAGE, MI 49024-1312
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011248
MI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
08/22/2022
Last updated
11/26/2024
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