Provider Demographics
NPI:1609411032
Name:DABNEY, LOGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:
Last Name:DABNEY
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 1:5525 MILLS CIVIC PKWY STE 120A
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5311
Mailing Address - Country:US
Mailing Address - Phone:515-422-9552
Mailing Address - Fax:
Practice Address - Street 1:5525 MILLS CIVIC PKWY STE 120A
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5311
Practice Address - Country:US
Practice Address - Phone:515-422-9552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-08
Last Update Date:2019-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA098663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor