| Tina M Logan, RPT | |
|
2555 Highway 78 E, Jasper, AL 35501-3433 | |
| (205) 385-7919 | |
| (205) 803-6458 |
| Full Name | Tina M Logan |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 2555 Highway 78 E, Jasper, Alabama |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073654778 | NPI | - | NPPES |
| 71-0945220 | Other | AL | EMPLOYER TAX ID |
| 63-1196634 | Other | AL | EMPLOYER TAX ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | PTH 3715 (Alabama) | Primary |
| Provider Name | Drayer Physical Therapy-alabama, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1023440583 PECOS PAC ID: 5395970560 Enrollment ID: O20150417000513 |
| Mailing Address | Practice Location Address |
|---|---|
| Tina M Logan, RPT 1200 Corporate Dr Ste 400, Hoover, AL 35242-5424 Ph: (423) 238-7217 | Tina M Logan, RPT 2555 Highway 78 E, Jasper, AL 35501-3433 Ph: (205) 385-7919 |
Chandler Gentz, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 200 N Airport Rd Ste 110, Jasper, AL 35504 Phone: 205-387-3267 | |
Jonathan Carreon Mendoza, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 421 Golf Course Rd, Jasper, AL 35504 Phone: 205-544-1941 | |
Zachary Alexander, LPTA Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3400 Highway 78 E, Jasper, AL 35501 Phone: 205-387-4000 | |
Katherine David, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2555 Highway 78 E, Jasper, AL 35501 Phone: 334-380-4930 | |
Erin Howell, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3400 Highway 78 E, Jasper, AL 35501 Phone: 205-387-4000 | |
Mrs. Diane L Coffey, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2555 Highway 78 E, Jasper, AL 35501 Phone: 205-385-7919 |