Provider Demographics
NPI:1316428071
Name:KLAHN, LOGAN WILLIAM (PT, DPT)
Entity type:Individual
Prefix:
First Name:LOGAN
Middle Name:WILLIAM
Last Name:KLAHN
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 ROCKY MOUNTAIN AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80538-9071
Mailing Address - Country:US
Mailing Address - Phone:970-624-4128
Mailing Address - Fax:970-490-4340
Practice Address - Street 1:175 INVERNESS DR W STE 100
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5066
Practice Address - Country:US
Practice Address - Phone:303-694-3333
Practice Address - Fax:303-694-9666
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist