Logan Smith, PT, DPT | |
44191 Plymouth Oaks Blvd Ste 800, Plymouth, MI 48170-2538 | |
(734) 463-3007 | |
(734) 203-0901 |
Full Name | Logan Smith |
---|---|
Gender | Male |
Speciality | Physical Therapist |
Location | 44191 Plymouth Oaks Blvd Ste 800, Plymouth, Michigan |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215634316 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 5501302333 (Michigan) | Primary |
Provider Name | Ethos Physical Therapy Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1225757719 PECOS PAC ID: 6507235298 Enrollment ID: O20221220002280 |
Mailing Address | Practice Location Address |
---|---|
Logan Smith, PT, DPT 44191 Plymouth Oaks Blvd Ste 800, Plymouth, MI 48170-2538 Ph: (810) 853-0086 | Logan Smith, PT, DPT 44191 Plymouth Oaks Blvd Ste 800, Plymouth, MI 48170-2538 Ph: (734) 463-3007 |
Tyler Donald Bolley, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9368 N Lilley Rd, Plymouth, MI 48170 Phone: 734-416-3900 Fax: 734-416-3903 | |
Eric Normand Duquette, Physical Therapist Medicare: Medicare Enrolled Practice Location: 801 W Ann Arbor Trl Ste 220, Plymouth, MI 48170 Phone: 866-991-0900 | |
Joel Hegeman, Physical Therapist Medicare: Medicare Enrolled Practice Location: 801 W Ann Arbor Trl, Suite 220, Plymouth, MI 48170 Phone: 866-991-0900 | |
Emily Jean Soto, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 580 Forest Ave Ste 1b, Plymouth, MI 48170 Phone: 734-673-8545 Fax: 734-545-8135 | |
Dorene Dudek, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 14300 N Beck Rd, Plymouth, MI 48170 Phone: 248-380-6222 Fax: 248-380-6224 | |
Heather Ngo, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 801 W Ann Arbor Trl Ste 220, Plymouth, MI 48170 Phone: 866-991-0900 | |
Aaron Hinton, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 801 W Ann Arbor Trl Ste 220, Plymouth, MI 48170 Phone: 866-991-0900 |