Individual
AUTUMN LOGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
5885 SUNNYBROOK DR STE D100, SIOUX CITY, IA 51106-4250
(712) 266-2700
Mailing address
24997 JADE AVE, MERRILL, IA 51038-8769
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
133164
IA
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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