Most Relevant Information
Provider Data
| NPI Number: | 1003579889 |
| Provider Name: | LOGAN BODE HOWARD PA |
| Entity Type: | Individual |
| Taxonomy Code: | 363A00000X |
| Specialty: | Physician Assistant |
| License Number: | PA2728 |
Most Important Dates
| Enumeration Date: | 10/18/2021 |
| Last Updated: | 02/07/2023 |
Provider Practice Location
10635 PROFESSIONAL CIR STE A
RENO
NV
895215836
Practice Location Phone/Fax
| Phone: | 7758520505 |
| Fax: | 7758520508 |
Provider Mailing Location
10635 PROFESSIONAL CIR STE A
RENO
NV
895215836
Provider Mailing Phone/Fax
| Phone: | 7758520505 |
| Fax: | 7758520508 |