Individual
MRS. PAULA RENEE LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10331 UNIVERSITY AVE, CLIVE, IA 50325-6472
(515) 225-2694
Mailing address
30352 KASTEN RIDGE LN, ADEL, IA 50003-8728
(515) 993-4270
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
18361
IA
Other
Enumeration date
02/15/2010
Last updated
02/15/2010
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