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Search › Virginia › Physical Therapy Assistant

Logan Broache

NPI 1790511087 · on the registry since 2024

Practice

Address
7600 Autumn Park Way
Mechanicsville, VA 23116
Phone
(804) 730-0009
Organisation at this address
Sri Sai Raj,Llc
Autumn Corporation
Inferred from a shared address, not stated in the registry.
Clinicians at this address
29

Registry record

Primary taxonomy
Physical Therapy Assistant
225200000X
Licence states on file
VA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2024-09-12
Status
Not present in the most recent federal file

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Virginia