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Organization

LOGAN C MARTIN PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LOGAN C MARTIN D.C. (PRESIDENT)
(208) 292-4873
Entity
Organization

Contact information

Practice address
1019 W LACROSSE AVE, COEUR D ALENE, ID 83814-2418
(208) 292-4873
(208) 292-4875
Mailing address
1911 N QUAIL RUN BLVD, POST FALLS, ID 83854-6018
(208) 292-4873
(208) 292-4875

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIA-1192
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1678934
PTAN
ID
Enumeration date
04/24/2012
Last updated
04/24/2012
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