| Doctor Name: | LOGAN THOMAS PETTZ |
| NPI Number: | 1104292044 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPT |
| License Number: | 2015028950 |
| Business Practice Address: | 9151 Ne 81st Ter Kansas City, MO - 641581294 |
| Business Phone Number: | 8164154971 |
| Business Fax Number: | |
| Mailing Address: | 7917 N Flintlock Rd, G KANSAS CITY |
| State: | MO |
| Postal Code: | 641581126 |
| Phone Number: | 8163526967 |
| Fax Number: | |
| NPI Enumeration Date: | 08/14/2015 |
| NPI Last Update Date: | 08/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2015028950 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |