Healthcare Provider Details

I. General information

NPI: 1902863988
Provider Name (Legal Business Name): DEBORAH K LOFTUS PT, OCS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 09/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W156N11072 PILGRIM RD
GERMANTOWN WI
53022-4247
US

IV. Provider business mailing address

W156N11072 PILGRIM RD
GERMANTOWN WI
53022-4247
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-0340
  • Fax: 262-502-1384
Mailing address:
  • Phone: 262-251-0340
  • Fax: 262-502-1384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2597-024
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: