MEDICARE: KAYLA NAMIKO LOFFER PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	62024	OR

General Provider Information

NPI Number	:	1679016406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA NAMIKO LOFFER PT, DPT

Provider Business Mailing Address
First Line	:	137 NE MILL STREET
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526
Country	:	US
Telephone Number	:	541-226-2118
Fax Number	:	541-226-2346

Provider Business Practice Location Address
First Line	:	137 NE MILL STREET
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526
Country	:	US
Telephone Number	:	541-226-2118
Fax Number	:	541-226-2346

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/28/2016
Last Update Date	:	01/08/2026

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