Provider Demographics
NPI:1568848844
Name:SWAIM, LOGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:
Last Name:SWAIM
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 1:8209 NATURES WAY
Mailing Address - Street 2:UNIT 115
Mailing Address - City:LAKEWOOD RANCH
Mailing Address - State:FL
Mailing Address - Zip Code:34202-4218
Mailing Address - Country:US
Mailing Address - Phone:941-877-1507
Mailing Address - Fax:
Practice Address - Street 1:8209 NATURES WAY
Practice Address - Street 2:UNIT 115
Practice Address - City:LAKEWOOD RANCH
Practice Address - State:FL
Practice Address - Zip Code:34202-4218
Practice Address - Country:US
Practice Address - Phone:941-877-1507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH11541111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor