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1952999294
LOGAN WILLIAM ELLIS
GREENVILLE, SC
NPI
1952999294
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2021-01-04
Last Update Date
2021-08-10
Business Address
LOGAN WILLIAM ELLIS
200 PATEWOOD DR STE C300
GREENVILLE, SC 29615-6324
Phone number: 864-908-0122
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Mailing Address
LOGAN WILLIAM ELLIS
300 E MCBEE AVE FL 4
GREENVILLE, SC 29601-2842
Phone number: 803-434-1335
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