Provider Demographics
NPI:1649224106
Name:LOAR, JOHN W (PT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:W
Last Name:LOAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11801 INDUSTRIAL PARK ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-5139
Mailing Address - Country:US
Mailing Address - Phone:301-729-3485
Mailing Address - Fax:301-729-0158
Practice Address - Street 1:11801 INDUSTRIAL PARK ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-5139
Practice Address - Country:US
Practice Address - Phone:301-729-3485
Practice Address - Fax:301-729-0158
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19139225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7302418000Medicaid
2114693OtherMAMSI
0012OtherCAREFIRST BCBS OF DC/NCA
MD62023901OtherBLUE CROSS BLUE SHIELD
P00094708OtherRAILROAD MEDICARE
WV1017320OtherWORKERS' COMPENSATION
7720660OtherAETNA
WV1017320OtherWORKERS' COMPENSATION