Provider Demographics
NPI:1679135586
Name:FOCHT, LOGAN (DPT)
Entity Type:Individual
Prefix:
First Name:LOGAN
Middle Name:
Last Name:FOCHT
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 1:415 S MILLER ST
Mailing Address - Street 2:
Mailing Address - City:SHILLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19607-3201
Mailing Address - Country:US
Mailing Address - Phone:610-301-4320
Mailing Address - Fax:
Practice Address - Street 1:4301 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-1370
Practice Address - Country:US
Practice Address - Phone:610-927-4136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist