Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT006797L | PA |
NPI | 1003117367 |
---|---|
Provider Name | Marcia J Logan |
First Address | Pittsburgh, PA 15202-3428 |
Second Address | Pittsburgh, PA 15202-3428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2010 |
Last Update Date | 07/10/2020 |