Individual
LOGAN L BIANCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
4404 BARRANCA LN STE 101, CASTLE ROCK, CO 80104-7419
(720) 733-5260
(720) 733-5261
Mailing address
715 S 9TH ST, CANON CITY, CO 81212-4911
(719) 269-8820
(719) 204-0230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0006652
CO
363A00000X
Physician Assistant
PA219016
OR
Other
Enumeration date
03/22/2021
Last updated
04/29/2025
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