Organization
NORTHWEST SPINE & WELLNESS CENTER, LLC
Active
Other names
Logan Chiropractic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES MARK LOGAN D.C. (MEMBER)
(541) 776-4554
Entity
Organization
Contact information
Practice address
835 BENNETT AVE, MEDFORD, OR 97504-6715
(541) 776-4554
Mailing address
835 BENNETT AVE, MEDFORD, OR 97504-6715
(541) 776-4554
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
3440
OR
Other
Enumeration date
10/29/2013
Last updated
10/29/2013
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