Individual
LAWRENCE WILLIAM LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
546 MARJORIE PL, MACON, GA 31204-1970
(478) 405-5957
Mailing address
546 MARJORIE PL, MACON, GA 31204-1970
(478) 405-5957
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0202004657
VA
183500000X
Pharmacist
Primary
RPH020095
GA
Other
Enumeration date
11/28/2008
Last updated
11/28/2008
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