Provider Demographics
NPI:1205133022
Name:LOFTON, TEKEDRA DENISE
Entity type:Individual
Prefix:
First Name:TEKEDRA
Middle Name:DENISE
Last Name:LOFTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 TOWN CTR
Mailing Address - Street 2:SUITE 2001
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-1110
Mailing Address - Country:US
Mailing Address - Phone:248-352-0314
Mailing Address - Fax:248-281-0759
Practice Address - Street 1:21700 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 110
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4906
Practice Address - Country:US
Practice Address - Phone:248-809-9941
Practice Address - Fax:248-809-2480
Is Sole Proprietor?:No
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist