Provider Demographics
NPI:1114009735
Name:LOFTIS, IOANA M (PT)
Entity Type:Individual
Prefix:
First Name:IOANA
Middle Name:M
Last Name:LOFTIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 PHILADELPHIA ST
Mailing Address - Street 2:
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15701-2133
Mailing Address - Country:US
Mailing Address - Phone:724-388-9769
Mailing Address - Fax:724-465-2168
Practice Address - Street 1:1020 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4649
Practice Address - Country:US
Practice Address - Phone:864-455-2319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5164225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC186130OtherMEDCOST
SCTH1655Medicaid
SCQ34015Medicare UPIN