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1598533366
BROOKE LEXENA LOGUE
GRANTS PASS, OR
NPI
1598533366
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: OR PA217205)
Enumeration Date
2023-12-12
Last Update Date
2024-02-06
Business Address
BROOKE LEXENA LOGUE
741 NE 6TH ST
GRANTS PASS, OR 97526-1556
Phone number: 541-471-2701
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Mailing Address
BROOKE LEXENA LOGUE
2045 HAVILAND DR
GRANTS PASS, OR 97527-5116
Phone number:
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