Provider Demographics
NPI:1922554724
Name:LOMINAC, MICHAEL STEVEN (PT, DPT, CCI)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:LOMINAC
Suffix:
Gender:M
Credentials:PT, DPT, CCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CRESTON LN STE D
Mailing Address - Street 2:
Mailing Address - City:SOLOMONS
Mailing Address - State:MD
Mailing Address - Zip Code:20688-3076
Mailing Address - Country:US
Mailing Address - Phone:410-231-2207
Mailing Address - Fax:833-542-1343
Practice Address - Street 1:20 CRESTON LN STE D
Practice Address - Street 2:
Practice Address - City:SOLOMONS
Practice Address - State:MD
Practice Address - Zip Code:20688-3076
Practice Address - Country:US
Practice Address - Phone:410-231-2207
Practice Address - Fax:833-542-1343
Is Sole Proprietor?:No
Enumeration Date:2016-08-31
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26275225100000X
NCP16418225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist