Logan Berlof, PT, DPT, CSCS

Individual provider Active NPI Sports Physical Therapist · Prosper, TX

NPI 1831972652 · NPPES record last updated Aug 15, 2023

Key facts

NPI
1831972652
Entity type
Individual (NPI type 1)
Primary specialty
Sports Physical Therapist 2251S0007X
License
1379072 (TX)
Practice address
700 Industry Way Ste 40
Prosper, TX 75078-3116
Phone
(469) 919-6299
NPI assigned
Aug 15, 2023
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
1379072TXMDSports Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Built 4 It Athletics LLC Current
since Aug 27, 2023
Accepting new patients

Locations

700 Industry Way
Ste 40
Prosper, TX 75078
Phone (469) 919-6299

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical Therapist 2251S0007X 1379072 TX Yes

Addresses

Primary practice location

700 Industry Way Ste 40
Prosper, TX 75078-3116

Mailing address

6688 John Hickman Pkwy Apt 509
Frisco, TX 75034-9629

Other providers in Prosper, TX

All providers in Prosper, TX · Sports Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.