South Logan Family Practice

NPI #1659789733 in Denver, Colorado

Provider Information

NPI Number: 1659789733
Entity Type: Organization
Organization Name: South Logan Family Practice
Primary Specialty: Physician Assistant
Enumeration Date: Aug 1, 2014
Last Updated: Aug 1, 2014

Practice Location

Address: 895 S LOGAN ST
City: Denver
State: Colorado
ZIP Code: 80209-4127
Phone: (303) 733-3764

Authorized Official

Name: SHAUNTAE TALA MURPHY
Title: PA
Phone: (303) 733-3764

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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