Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Logan Bradley, DPT

Individual provider Physical Therapist · NPI 1336661321

Logan Bradley, DPT is a Physical Therapist in Private Practice in Idaho Falls, Idaho. Qualified in 2017, 9 years ago. Practices with Ellis Physical Therapy and Associates LLC, a 3-clinician group and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

3100 S Woodruff Ave
Idaho Falls, ID 83404-8310
Phone: (208) 523-8879
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X

Record details

NPI number1336661321
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedJuly 11, 2017
Last updated in NPPESMay 13, 2020
Certification dateMay 13, 2020
Mailing address3100 S Woodruff Ave, Idaho Falls, ID 83404-8310

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Ellis Physical Therapy And Associates Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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