Elizabeth Logue Physical Therapy.Inc

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

21503 Issued in CA

Legal business name

ELIZABETH LOGUE PHYSICAL THERAPY.INC

Practice address

121 19TH St Apt 15
Huntington Beach, CA 92648-3945

Phone

(657) 464-9628

Fax

(714) 594-3830

NPI assigned

Feb 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Elizabeth Ann Logue, P. T.

Title

President

Phone

(657) 464-9628

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309824000000",
    "number": "1548397474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 19TH ST APT 15",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483945",
            "telephone_number": "657-464-9628",
            "fax_number": "714-594-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 19TH ST APT 15",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926483945",
            "telephone_number": "657-464-9628",
            "fax_number": "714-594-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH LOGUE PHYSICAL THERAPY.INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2011-07-05",
        "status": "A",
        "authorized_official_last_name": "LOGUE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "657-464-9628",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P. T."
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "21503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Physical Therapist in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.