Individual
JOHNATHAN LAWRENCE LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
480 RESERVOIR AVE, CRANSTON, RI 02910-1729
(410) 270-2500
Mailing address
480 RESERVOIR AVE, CRANSTON, RI 02910-1729
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/18/2026
Last updated
05/18/2026
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