Provider Demographics
NPI:1548270937
Name:WOMEN HEALTH OF LOGAN COUNTY, PC
Entity type:Organization
Organization Name:WOMEN HEALTH OF LOGAN COUNTY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RYSKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-526-8100
Mailing Address - Street 1:1405 S 8TH AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:STERLING
Mailing Address - State:CO
Mailing Address - Zip Code:80751-4563
Mailing Address - Country:US
Mailing Address - Phone:970-526-8100
Mailing Address - Fax:970-521-3183
Practice Address - Street 1:1405 S 8TH AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:STERLING
Practice Address - State:CO
Practice Address - Zip Code:80751-4563
Practice Address - Country:US
Practice Address - Phone:970-526-8100
Practice Address - Fax:970-521-3183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43490207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty