PRUDENCE LOGAN

NORMAL, IL
NPI1457658288
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy246ZS0410X Specialist/Technologist, Other, Surgical Technologist
Enumeration Date2011-02-14
Last Update Date2011-02-14
Business Address
-- PRUDENCE LOGAN ST
112 BOEYKENS PL STE 2A
NORMAL, IL 61761-2152
Phone number: 309-846-4716
Mailing Address
-- PRUDENCE LOGAN ST
112 BOEYKENS PL STE 2A
NORMAL, IL 61761-2152
Phone number: 309-846-4716
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