| NPI | 1992100622 |
|---|---|
| Former Legal Business Name | SOUTH LOGAN FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | GEORGETTE V LAWS-WILLIS Office Manager 303-733-3764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |