Individual
LOGAN POLSINELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
151B RUTLEDGE AVE, CHARLESTON, SC 29425-8903
(843) 792-4067
Mailing address
197 SAINT PHILIP ST, CHARLESTON, SC 29403-5429
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
272678
SC
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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