Individual
LOGAN SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6201 STELLHORN RD, FORT WAYNE, IN 46815-5349
(260) 485-0755
Mailing address
214 E EDGERTON ST, HICKSVILLE, OH 43526-1407
(419) 487-3991
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
45024079A
IN
Other
Enumeration date
08/01/2024
Last updated
08/01/2024
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