LOGAN SPARKS

DEARBORN, MI
NPI1306436845
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601010419)
Enumeration Date2021-01-19
Last Update Date2023-03-21
Business Address
LOGAN SPARKS PA
3815 PELHAM ST STE 13
DEARBORN, MI 48124-3852
Phone number: 313-722-4683
Mailing Address
LOGAN SPARKS PA
3815 PELHAM ST STE 13
DEARBORN, MI 48124-3852
Phone number: 313-722-4683
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