Individual
JENNIE LYNFRED LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3868 S CENTINELA AVE APT 12, LOS ANGELES, CA 90066-4459
(818) 619-4041
Mailing address
3868 S CENTINELA AVE APT 12, LOS ANGELES, CA 90066-4459
(818) 619-4041
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
Primary
20293
CA
Other
Enumeration date
10/10/2017
Last updated
10/10/2017
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