Provider Demographics
NPI:1982695490
Name:LOGIC, TODD A (MPT)
Entity Type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:LOGIC
Suffix:
Gender:M
Credentials:MPT
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Mailing Address - Street 1:676 DEKALB PIKE
Mailing Address - Street 2:SUITE 205 APEX PHYSICAL THERAPY
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1223
Mailing Address - Country:US
Mailing Address - Phone:610-270-0370
Mailing Address - Fax:610-270-0374
Practice Address - Street 1:341 10TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-3806
Practice Address - Country:US
Practice Address - Phone:610-792-8100
Practice Address - Fax:610-792-1535
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-03
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
PAPT013389225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
061952QYQMedicare ID - Type Unspecified