Individual
MR. JEFFERY A LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC,LLC
Contact information
Practice address
222 AUBURN ST, STE 103, PORTLAND, ME 04103-6004
(207) 780-8880
(207) 773-0959
Mailing address
222 AUBURN ST, STE 103, PORTLAND, ME 04103-6004
(207) 780-8880
(207) 773-0959
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC157
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036445
BC/BS STAR
ME
01
—
1815546
CIGNA
ME
01
—
2425756
AETNA
ME
01
—
M23908
CIGNA-NH
ME
Enumeration date
07/18/2006
Last updated
07/08/2007
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