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1154171387
LOGAN FORTENBERRY
AURORA, CO
NPI
1154171387
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2024-03-22
Last Update Date
2024-03-22
Business Address
LOGAN FORTENBERRY MD
13123 E 16TH AVE
AURORA, CO 80045-7106
Phone number: 720-777-3846
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Mailing Address
LOGAN FORTENBERRY MD
13123 E 16TH AVE
AURORA, CO 80045-7106
Phone number:
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