Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Logan Michael Ben-Ezra, PT, DPT, CSCS

Individual provider Physical Therapist · NPI 1316756307

Logan Michael Ben-Ezra, PT, DPT, CSCS is a Physical Therapist in Woodbridge, Virginia. Practices as a sole proprietor. Licensed in Illinois.

Licensed in
IL
In the registry since
2025
Specialties on file
2
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

14605 Potomac Branch Dr Ste 300
Woodbridge, VA 22191-3337
Phone: (703) 490-1112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Physical Therapist Taxonomy 225100000X · Licence 070.027620 (IL)

Record details

NPI number1316756307
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT , CSCS
Sole proprietorYes
NPI enumeratedJanuary 3, 2025
Last updated in NPPESJanuary 3, 2025
Certification dateJanuary 3, 2025

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