Provider Demographics
NPI:1477075018
Name:LOGAN, ARTI RANA (DPT)
Entity Type:Individual
Prefix:
First Name:ARTI
Middle Name:RANA
Last Name:LOGAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 CALLE VIOLETAS
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4115
Mailing Address - Country:US
Mailing Address - Phone:760-608-7445
Mailing Address - Fax:
Practice Address - Street 1:1540 CALLE VIOLETAS
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4115
Practice Address - Country:US
Practice Address - Phone:760-608-7445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT38208225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty