Provider Demographics
NPI:1750401105
Name:LOFTIS, TIFFANY K (PT)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:K
Last Name:LOFTIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:K
Other - Last Name:ARBUCKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10304 ELK CANYON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-6615
Mailing Address - Country:US
Mailing Address - Phone:405-620-4410
Mailing Address - Fax:405-470-3345
Practice Address - Street 1:7100 SOUTH I-35 SERVICE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73149
Practice Address - Country:US
Practice Address - Phone:405-632-1002
Practice Address - Fax:405-632-3131
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2017-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2668225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist