Individual
LOGAN DEROIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
535 N LOCUST GROVE RD STE 170, MERIDIAN, ID 83642-9379
(208) 917-2660
Mailing address
535 N LOCUST GROVE RD STE 170, MERIDIAN, ID 83642-9379
(208) 917-2660
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
08/16/2019
Last updated
08/16/2019
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