Provider Demographics
NPI:1093309924
Name:LEGGETT, LOGAN CHASE (OTR/L)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:CHASE
Last Name:LEGGETT
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W CHAPEL HILL ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-3173
Mailing Address - Country:US
Mailing Address - Phone:912-347-5832
Mailing Address - Fax:912-347-5832
Practice Address - Street 1:605 W CHAPEL HILL ST APT 610
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-2771
Practice Address - Country:US
Practice Address - Phone:912-347-5832
Practice Address - Fax:912-347-5832
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2024-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16613225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist