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LOGAN CRIST

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1720528805

Individual Registrant:
 LOGAN  CRIST 
Gender: M
Not Sole Proprietor

Location and contact information for practice:
100 PMC DR  MEEKER, CO 81641-3181 US
Tel: 970-987-8125  Fax: --

Contact information for business:
100 PMC DRIVE  MEEKER, CO 81641 US
Tel: 970-987-8125  Fax: --

Registration Information:
NPI: 1720528805
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CO87-0788731

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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