Logan Raichle, | |
5013 Southport Crossing Way Ste 204, Southport, NC 28461-2206 | |
(910) 604-9550 | |
Not Available |
Full Name | Logan Raichle |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 5013 Southport Crossing Way Ste 204, Southport, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1104609148 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Benchmark Physical Therapy Of North Carolina Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1356894604 PECOS PAC ID: 1052609278 Enrollment ID: O20161004000926 |
Mailing Address | Practice Location Address |
---|---|
Logan Raichle, 1200 Corporate Dr Ste 400, Hoover, AL 35242-5424 Ph: (423) 558-0076 | Logan Raichle, 5013 Southport Crossing Way Ste 204, Southport, NC 28461-2206 Ph: (910) 604-9550 |
Jacob Kramell, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4002 Executive Park Blvd Ste 800, Southport, NC 28461 Phone: 910-477-6236 | |
Michelle Lee Phillips, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 902 N Howe St, Southport, NC 28461 Phone: 910-457-4789 Fax: 910-457-5824 | |
Angela Marie Doyle, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1517 N Howe St, Southport, NC 28461 Phone: 910-519-8380 | |
Pamela R Dehne, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 4002 Executive Park Blvd Ste 800, Southport, NC 28461 Phone: 910-477-6357 Fax: 910-477-6357 | |
Amanda Mcearl Tilyou, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4002 Executive Park Blvd Ste 800, Southport, NC 28461 Phone: 910-477-6236 Fax: 910-477-6357 | |
Mr. Nikolos William Boehmer, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4330 Southport Supply Road, Suite 201, Southport, NC 28461 Phone: 910-457-0113 Fax: 910-457-0114 |