Provider Demographics
NPI:1780342030
Name:CLARAHAN, LOGAN (DC)
Entity type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:
Last Name:CLARAHAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CLARMAR DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-2675
Mailing Address - Country:US
Mailing Address - Phone:608-318-5929
Mailing Address - Fax:608-318-5922
Practice Address - Street 1:201 W VERONA AVE
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-1456
Practice Address - Country:US
Practice Address - Phone:608-848-4227
Practice Address - Fax:608-848-4229
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5699-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor