Logan Primary Care Service Corp.
NPI #1023123346 in West Frankfort, Illinois
Provider Information
- NPI Number
- 1023123346
- Entity Type
- Organization
- Organization Name
- Logan Primary Care Service Corp.
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Aug 19, 2006
- Last Updated
- Mar 16, 2012
Practice Location
- Address
- 502 W ST LOUIS
- City
- West Frankfort
- State
- Illinois
- ZIP Code
- 62896
- Phone
- (618) 997-3400
Authorized Official
- Name
- TARA G DEATON
- Title
- ADMINISTRATOR
- Phone
- (618) 993-3300
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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