Slack, Logan

Slack, Logan is an individual health care provider with primary practice located at 1300 Anne St Nw , Bemidji MN 56601-5103. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Slack, Logan can be contacted via phone (218) 751-9746.

Contact Information

Primary practice address
1300 Anne St Nw Bemidji MN 56601-5103
Phone: (218) 751-9746
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 14888 Minnesota

Profile Details

NPI number 1982328480
LBN Legal business name Slack, Logan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 28th, 2022
Last updated May 20th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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