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Individual
LOGAN TYLER NORTH
Active
Individual
LOGAN TYLER NORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2020035024
MO
111N00000X
Chiropractor
5562
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020035024
STATE LICENSE BOARD
MO
01
—
5562
STATE LICENSE BOARD
KY
Enumeration date
01/09/2018
Last updated
10/19/2020
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