Provider Demographics
NPI:1891836086
Name:LOEDDING, JOSEPH DAVID (CMTPT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DAVID
Last Name:LOEDDING
Suffix:
Gender:M
Credentials:CMTPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 HAZEN RD
Mailing Address - Street 2:
Mailing Address - City:SHARPSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16150-1726
Mailing Address - Country:US
Mailing Address - Phone:724-962-3508
Mailing Address - Fax:
Practice Address - Street 1:32 JEFFERSON AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3354
Practice Address - Country:US
Practice Address - Phone:724-346-3774
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PANA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist