Provider Demographics
NPI:1427203249
Name:LOGICAL THERAPY, LLC
Entity Type:Organization
Organization Name:LOGICAL THERAPY, LLC
Other - Org Name:LOGICAL THERAPY WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:D
Authorized Official - Last Name:NOILES
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, MT
Authorized Official - Phone:386-673-1880
Mailing Address - Street 1:226 N NOVA RD # 384
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-5124
Mailing Address - Country:US
Mailing Address - Phone:386-673-1880
Mailing Address - Fax:
Practice Address - Street 1:555 W GRANADA BLVD STE D9
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-9400
Practice Address - Country:US
Practice Address - Phone:386-673-1880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 50432225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty