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General NPI Number Information
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NPI Number | 1548323140
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Entity Type | Individual
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Provider Name | MARK LOGAN D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 400 FRANKLIN ST STE 306
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City | BRAINTREE
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State | MA
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Zip | 02184-5540
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Country | US
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Telephone | 781-843-8187
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Fax | 781-899-9233
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Provider Business Mailing Address
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Address Line | 400 FRANKLIN ST STE 306
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City | BRAINTREE
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State | MA
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Zip | 02184-5540
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Country | US
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Telephone | 781-843-8187
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Fax | 781-899-9233
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 1465
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License Number State | MA
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