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General NPI Number Information
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NPI Number | 1306016175
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Entity Type | Organization
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Legal Business Name | LOGSDON CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 03/07/2008
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Last Update Date | 03/07/2008
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Provider Practice Location Address
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Address Line | 1807 S. 9TH
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City | CHICKASHA
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State | OK
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Zip | 73018
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Country | US
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Telephone | 405-224-0884
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Fax | 405-224-0887
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Provider Business Mailing Address
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Address Line | 1807 S. 9TH
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City | CHICKASHA
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State | OK
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Zip | 73018
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Country | US
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Telephone | 405-224-0884
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Fax | 405-224-0887
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Authorized Official
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Title or Position | CHIROPRACTOR
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Name | DR. JENNIFER ANN LOGSDON
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Credential | DC
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Telephone | 405-224-0884
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 3338
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License Number State | OK
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