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General NPI Number Information
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NPI Number | 1952887671
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Entity Type | Organization
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Legal Business Name | LOGAN J. FRAHM
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 978 E LAKE AVE
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City | WATSONVILLE
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State | CA
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Zip | 95076-3404
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Country | US
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Telephone | 831-288-0627
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Fax | 831-851-3289
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Provider Business Mailing Address
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Address Line | 910 CAPITOLA AVE APT 11
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City | CAPITOLA
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State | CA
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Zip | 95010-2121
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Country | US
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Telephone | 619-887-0179
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LOGAN JAMES FRAHM
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Credential | DC
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Telephone | 831-288-0627
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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 | DC-30883
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License Number State | CA
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