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General NPI Number Information
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NPI Number | 1295929206
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Entity Type | Individual
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Provider Name | JOSEPH LOIACANO P.T.A.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2007
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Last Update Date | 09/03/2007
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Provider Practice Location Address
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Address Line | 2620 CENTENARY BLVD SUITE 202
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City | SHREVEPORT
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State | LA
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Zip | 71104-3356
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Country | US
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Telephone | 866-730-0707
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 TURFWAY PARK DR
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City | ROBINSON
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State | TX
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Zip | 76706-5679
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Country | US
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Telephone | 254-662-6474
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2048800
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License Number State | TX
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