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LOGAN RECKORD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
900 CENTENNIAL BLVD, #202, VOORHEES, NJ 08043-4637
(856) 342-2034
Mailing address
3130 W MASTER ST, PHILADELPHIA, PA 19121-4424
(717) 283-6162

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
25MP00345600
NJ

Other

Enumeration date
09/29/2014
Last updated
09/29/2014
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