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NPI Code Detail

MEDICARE: LOGAN HARRIS PT, DPT

MEDICARE: LOGAN HARRIS PT, DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist14775TN

General Provider Information

NPI Number : 1366149809
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOGAN HARRIS PT, DPT
Provider Business Mailing Address
First Line : 325 W MORRIS BLVD STE B
Second Line :
City : MORRISTOWN
State : TN
Zip : 37813-2237
Country : US
Telephone Number : 423-375-8907
Fax Number : 423-822-5514
Provider Business Practice Location Address
First Line : 900 W MAIN ST
Second Line :
City : ROGERSVILLE
State : TN
Zip : 37857-2448
Country : US
Telephone Number : 423-500-5600
Fax Number : 423-317-7773
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2023
Last Update Date : 02/03/2026

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