Individual
LOGAN M ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
8200 W CENTRAL AVE STE 5, WICHITA, KS 67212-3661
(316) 491-6482
Mailing address
8200 W CENTRAL AVE STE 5, WICHITA, KS 67212-3661
(316) 491-6482
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1-100206
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE
1-100206
KS
Enumeration date
04/23/2019
Last updated
04/23/2019
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