MEDICARE: SARAH LEIGH LOGAN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	4787	SC

General Provider Information

NPI Number	:	1477391563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH LEIGH LOGAN DC

Provider Business Mailing Address
First Line	:	2408 ASHLEY RIVER RD UNIT Z
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-4619
Country	:	US
Telephone Number	:	843-266-7534
Fax Number	:

Provider Business Practice Location Address
First Line	:	2408 ASHLEY RIVER RD UNIT Z
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-4619
Country	:	US
Telephone Number	:	843-266-7534
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2024
Last Update Date	:	07/15/2024

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Directions to “ SARAH LEIGH LOGAN DC” Practice Location

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