Provider Demographics
NPI:1356740740
Name:MILLS, LOGAN J (DC)
Entity type:Individual
Prefix:DR
First Name:LOGAN
Middle Name:J
Last Name:MILLS
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 1:12398 FM 423 STE 300
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-0154
Mailing Address - Country:US
Mailing Address - Phone:214-872-4220
Mailing Address - Fax:469-562-0059
Practice Address - Street 1:12398 FM 423 STE 300
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-0154
Practice Address - Country:US
Practice Address - Phone:214-872-4220
Practice Address - Fax:214-872-4240
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12718111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor