Organization
SOUTH LOGAN MEDICAL MANAGEMENT SVCS LLC
Active
Other names
South Logan Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGETTE V LAWS-WILLIS PR (OFFICE MANAGER)
(303) 733-3764
Entity
Organization
Contact information
Practice address
895 S LOGAN ST, DENVER, CO 80209-4127
(303) 733-3764
(303) 733-3764
Mailing address
895 S LOGAN ST, DENVER, CO 80209-4127
(303) 733-3764
(303) 733-3764
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
10/23/2014
Last updated
10/23/2014
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