Individual
BRIAN LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
45 PINE ST, 1ST MEDICAL GROUP, LANGLEY AFB, VA 23665-2025
(757) 764-6497
Mailing address
77 NEALY AVE, 1ST MEDICAL GROUP, LANGLEY AFB, VA 23665-2040
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
019940
GA
Other
Enumeration date
01/24/2007
Last updated
07/13/2007
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