RICHARD LANE LOGAN

CHICAGO, IL
NPI1063189132
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: IL  164008466)
Enumeration Date2021-08-26
Last Update Date2021-08-26
Business Address
Mr. RICHARD LANE LOGAN RD
2823 N CENTRAL PARK AVE APT 1F
CHICAGO, IL 60618-7326
Phone number: 317-364-2202
Mailing Address
Mr. RICHARD LANE LOGAN RD
2823 N CENTRAL PARK AVE APT 1F
CHICAGO, IL 60618-7326
Phone number: 317-364-2202
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