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Organization
LOGOS OUTPATIENT CLINIC LLC
Active
Organization
LOGOS OUTPATIENT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANNY EUGENE ROBERTSON MSPT (CLINIC DIRECTOR PRESIDENT)
(828) 264-0501
Entity
Organization
Contact information
Practice address
726 STATE FARM RD, SUITE B, BOONE, NC 28607
(828) 264-0501
(828) 262-0935
Mailing address
726 STATE FARM ROAD, SUITE B, BOONE, NC 28607
(828) 264-0501
(828) 262-0935
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3307
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011W4
BCBSNC
NC
05
—
7272080
—
NC
01
—
75936
MEDCOST
NC
Enumeration date
01/20/2006
Last updated
03/27/2008
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