Most Relevant Information
Provider Data
| NPI Number: | 1003671546 |
| Provider Name: | LOGAN BRUNO |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/14/2024 |
| Last Updated: | 02/14/2024 |
Provider Practice Location
3095 KETTERING BLVD
MORAINE
OH
454391983
Practice Location Phone/Fax
| Phone: | 9372938300 |
| Fax: |
Provider Mailing Location
3095 KETTERING BLVD
MORAINE
OH
454391983
Provider Mailing Phone/Fax
| Phone: | 9372938300 |
| Fax: |