Organization
LOGAN PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DOUCETTE PT (OWNER)
(435) 752-5200
Entity
Organization
Contact information
Practice address
2310 N 400 E, SUITE C, LOGAN, UT 84341-1788
(435) 752-5200
(435) 752-5228
Mailing address
PO BOX 6518, 2310 NORTH 400 EAST SUITE C, NORTH LOGAN, UT 84341-6518
(435) 752-5200
(435) 752-5228
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1162582401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
326689687024-N0654
—
UT
Enumeration date
02/20/2007
Last updated
08/22/2020
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