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Individual

LOGAN P CHAMBERLAIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC, ATC

Contact information

Practice address
1332 W ARCH HAVEN AVE STE C, BLOOMINGTON, IN 47403-2078
(812) 333-7447
(812) 333-7442
Mailing address
6296 W. BOGGSTOWN RD., BOGGSTOWN, IN 46110

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08003143A
IN
2255A2300X
Athletic Trainer

Other

Enumeration date
03/17/2015
Last updated
01/15/2020
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