Individual
LOGAN POTVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
802 E GORHAM ST, MADISON, WI 53703-1524
(608) 280-3700
Mailing address
25 KESSEL CT STE 105, MADISON, WI 53711-6227
(608) 280-2700
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/09/2019
Last updated
04/09/2019
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