Healthcare Provider Details

I. General information

NPI: 1205761418
Provider Name (Legal Business Name): LOGAN SPEARS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1183 BROCK MCVEY DR STE D
LEXINGTON KY
40509-4166
US

IV. Provider business mailing address

105 PURCELL DR APT A
RICHMOND KY
40475-3532
US

V. Phone/Fax

Practice location:
  • Phone: 859-213-0651
  • Fax:
Mailing address:
  • Phone: 606-794-0721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number309252
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: