Individual
KENNETH GERATD LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
100 DEL MAR GARDENS DRIVE, HENDERSON, NV 89074
(702) 361-6111
Mailing address
9850 S. MARYLAND PKWY PMB 358, SUITE A5, LAS VEGAS, NV 89183
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
51576
CA
225200000X
Physical Therapy Assistant
Primary
A-1452
NV
Other
Enumeration date
04/19/2023
Last updated
04/19/2023
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