Individual ProviderCasey Nicole LoganPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6385 Corporate Dr Ste 307, Colorado Springs, CO 80919-5913(719) 219-9795(813) 765-1445PECOS EnrollmentBased on the most recent information from CMS, provider Casey Nicole Logan does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:41 AM.Profile DetailsProvider ID1346023645Provider TypeIndividualFull NameLogan, Casey NicoleCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date8/18/2023Last Updated11/14/2024Contact InformationPractice LocationPractice Address6385 Corporate Dr Ste 307, Colorado Springs, CO 80919-5913Phone(719) 219-9795FaxUnlisted FaxMailing LocationMailing Address6173 Lantana Light Vw, Colorado Springs, CO 80922-3456Phone(813) 765-1445FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePTL.0019448ColoradoCode2251X0800XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT40541Florida