Individual
DR. CHARLES MARK LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1064 E JACKSON STREET, MEDFORD, OR 97504
(541) 776-4554
(541) 776-0954
Mailing address
1064 E JACKSON STREET, MEDFORD, OR 97504
(541) 776-4554
(541) 776-0954
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3440
OR
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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