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Individual
JOHN LOGAN FOX
Active
Individual
JOHN LOGAN FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT26110
CA
2251S0007X
Sports Physical Therapist
PT26110
CA
2251X0800X
Orthopedic Physical Therapist
PT26110
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT261100
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
09/14/2006
Last updated
10/10/2012
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