Provider Demographics
NPI:1407403595
Name:LOEFFLER, LAURIE (DPT)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:LOEFFLER
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 1:9568 N BARTON AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-4001
Mailing Address - Country:US
Mailing Address - Phone:305-753-9228
Mailing Address - Fax:
Practice Address - Street 1:4969 E MCKINLEY AVE STE 107
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93727-1968
Practice Address - Country:US
Practice Address - Phone:559-319-1725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA297248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist