Logan Family Practice, LLC
NPI #1902044597 in Logan, New Mexico
Provider Information
- NPI Number
- 1902044597
- Entity Type
- Organization
- Organization Name
- Logan Family Practice, LLC
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Feb 4, 2009
- Last Updated
- Feb 23, 2014
Practice Location
- Address
- 600 GALLEGOS
- City
- Logan
- State
- New Mexico
- ZIP Code
- 88426-7602
- Phone
- (575) 487-9000
Authorized Official
- Name
- MRS. LAJUANA DELL WILLIS, CFNP
- Title
- MEMBER
- Phone
- (575) 487-9000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
| Clinic/Center - Primary Care — Primary Care |
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