Brett Evan Logue, P.T.
Physical Therapist in Huntington Station, NY. Individual provider (NPI-1).
NPI number1720175615
StatusActive
Last updated in NPPESApr 27, 2021
Details
- NPI
- 1720175615
- Entity type
- Individual (NPI-1)
- Name
- Mr. Brett Evan Logue
- Credential
- P.T.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 10, 2006
- Certification date
- Apr 27, 2021
- Last updated
- Apr 27, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 017678-1 | NY | Yes |
Practice location
180 E Pulaski RdSuite C, Lower Level
Huntington Station, NY 11746-1915
Phone 631-396-1595 · Fax 631-396-1597
Mailing address
180 E Pulaski RdSuite C, Lower Level
Huntington Station, NY 11746-1915
Phone 631-396-1595 · Fax 631-396-1597
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