Provider Demographics
NPI:1992598882
Name:SCHWEITZER, LOGAN WOLF
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:WOLF
Last Name:SCHWEITZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:294 S 100 E
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3425
Mailing Address - Country:US
Mailing Address - Phone:435-669-7356
Mailing Address - Fax:
Practice Address - Street 1:294 S 100 E
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3425
Practice Address - Country:US
Practice Address - Phone:435-669-7356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider