Provider Demographics
NPI:1346688819
Name:LOFTUS, JENNA LYNN (DPT)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:LYNN
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12423 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2704
Mailing Address - Country:US
Mailing Address - Phone:913-638-7385
Mailing Address - Fax:
Practice Address - Street 1:2200 HARVARD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-2611
Practice Address - Country:US
Practice Address - Phone:785-842-0656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2013-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KST-03638225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist