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

Logan C Southwell, PTA

Individual provider Physical Therapy Assistant · NPI 1225750300

Logan C Southwell, PTA is a Physical Therapy Assistant in Phoenix, Arizona. Licensed in Arizona. Registered with an NPI since 2022.

Licensed in
AZ
In the registry since
2022
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

4141 N S Herrera Way
Phoenix, AZ 85012-1814
Phone: (602) 248-1550
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA-014540 (AZ)

Record details

NPI number1225750300
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedSeptember 14, 2022
Last updated in NPPESSeptember 14, 2022
Certification dateSeptember 14, 2022

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