Most Relevant Information
Provider Data
| NPI Number: | 1003649757 |
| Provider Name: | LOGAN MICHEL |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/20/2024 |
| Last Updated: | 08/20/2024 |
Provider Practice Location
1419 SALT SPRINGS RD
SYRACUSE
NY
132141300
Practice Location Phone/Fax
| Phone: | 3154454100 |
| Fax: |
Provider Mailing Location
1419 SALT SPRINGS RD
SYRACUSE
NY
132141300
Provider Mailing Phone/Fax
| Phone: | 3154454100 |
| Fax: |