Individual
MR. LOGAN WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1025 2ND ST NW, SALEM, OR 97304
(503) 371-0779
(610) 527-5770
Mailing address
3270 LIBERTY RD. S., SALEM, OR 97302
(503) 371-0779
(503) 371-0886
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
63239
OR
225100000X
Physical Therapist
PT025539
PA
Other
Enumeration date
08/09/2016
Last updated
09/19/2019
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