Provider Demographics
NPI:1972329308
Name:PATTERSON, LOGAN DIANE
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:DIANE
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 GARNSEY ST
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-3827
Mailing Address - Country:US
Mailing Address - Phone:937-670-2104
Mailing Address - Fax:
Practice Address - Street 1:209 GARNSEY ST
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-3827
Practice Address - Country:US
Practice Address - Phone:937-670-2104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care