Healthcare Provider Details

I. General information

NPI: 1245167642
Provider Name (Legal Business Name): LOGAN DANIEL MORRISON DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13892 TIMBER WAY STE T
BROADWAY VA
22815-3332
US

IV. Provider business mailing address

385 OLD FARM RD
LURAY VA
22835-3941
US

V. Phone/Fax

Practice location:
  • Phone: 540-901-0888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305215850
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: