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General NPI Number Information
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NPI Number | 1740175835
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Entity Type | Organization
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Legal Business Name | LOGAN AUTHEMENT ENTERPRISES
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 1152 CANAL BLVD
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City | THIBODAUX
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State | LA
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Zip | 70301-4534
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Country | US
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Telephone | 985-449-1000
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Fax | 985-449-1200
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Provider Business Mailing Address
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Address Line | 1152 CANAL BLVD
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City | THIBODAUX
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State | LA
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Zip | 70301-4534
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Country | US
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Telephone | 985-449-1000
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Fax | 985-449-1200
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Authorized Official
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Title or Position | OWNER
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Name | LOGAN AUTHEMENT
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Credential | DC
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Telephone | 985-859-2296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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