Healthcare Provider Details

I. General information

NPI: 1871465773
Provider Name (Legal Business Name): SUMMIT PM&R CONSULTING INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2025
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 S SAN TAN VILLAGE PKWY
GILBERT AZ
85295-6245
US

IV. Provider business mailing address

4065 S DEBRA DR
GILBERT AZ
85297-2221
US

V. Phone/Fax

Practice location:
  • Phone: 602-844-4855
  • Fax:
Mailing address:
  • Phone: 801-361-8086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LOGAN LEAVITT
Title or Position: PRESIDENT
Credential: DO
Phone: 801-361-8086