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1699305888
LOGAN J MIRANDETTE
GRAND RAPIDS, MI
NPI
1699305888
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2020-01-16
Last Update Date
2023-02-27
Business Address
LOGAN J MIRANDETTE PA-C
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525-6406
Phone number: 616-459-7101
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Mailing Address
LOGAN J MIRANDETTE PA-C
1111 LEFFINGWELL AVE NE
GRAND RAPIDS, MI 49525-6406
Phone number: 616-459-7101
Copy
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