Provider Demographics
NPI:1811374390
Name:LOGAN SLEEP DIAGNOSTICS, INC
Entity Type:Organization
Organization Name:LOGAN SLEEP DIAGNOSTICS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:435-752-1927
Mailing Address - Street 1:1395 N 400 E
Mailing Address - Street 2:SUITE C
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-7530
Mailing Address - Country:US
Mailing Address - Phone:435-752-1927
Mailing Address - Fax:435-752-4538
Practice Address - Street 1:1395 N 400 E
Practice Address - Street 2:SUITE C
Practice Address - City:LOGAN
Practice Address - State:UT
Practice Address - Zip Code:84341-7530
Practice Address - Country:US
Practice Address - Phone:435-752-1927
Practice Address - Fax:435-752-4538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory