Most Relevant Information
Provider Data
| NPI Number: | 1003272543 |
| Provider Name: | LOGAN STEWART WADDELL PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT015171 |
Most Important Dates
| Enumeration Date: | 01/13/2016 |
| Last Updated: | 01/13/2016 |
Provider Practice Location
8135 BEECHMONT AVE
WEST 269
CINCINNATI
OH
452556138
Practice Location Phone/Fax
| Phone: | 5133685212 |
| Fax: |
Provider Mailing Location
2614 ROYALWOODS CT
CINCINNATI
OH
452443655
Provider Mailing Phone/Fax
| Phone: | 5133685212 |
| Fax: |