Individual
MR. DEREK ALEXANDER LOGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
46 COLONIAL DR, ARLINGTON, MA 02474-8281
(617) 256-9074
Mailing address
46 COLONIAL DR, ARLINGTON, MA 02474-8281
(617) 256-9074
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15175
MA
Other
Enumeration date
01/12/2013
Last updated
01/12/2013
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