Provider Demographics
NPI:1730863929
Name:LOGGINS PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:LOGGINS PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-468-9401
Mailing Address - Street 1:2550 NICHOLSON ST
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20782-2606
Mailing Address - Country:US
Mailing Address - Phone:510-468-9401
Mailing Address - Fax:
Practice Address - Street 1:4944 WYACONDA RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2444
Practice Address - Country:US
Practice Address - Phone:510-468-9401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-09
Last Update Date:2023-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty