Provider Demographics
NPI:1811966724
Name:LOECKLE, TROY ALLEN (PT, RVT, RCP)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:ALLEN
Last Name:LOECKLE
Suffix:
Gender:M
Credentials:PT, RVT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2536 155TH ST
Mailing Address - Street 2:
Mailing Address - City:FLOYD
Mailing Address - State:IA
Mailing Address - Zip Code:50435-8011
Mailing Address - Country:US
Mailing Address - Phone:641-398-3003
Mailing Address - Fax:
Practice Address - Street 1:800 11TH ST
Practice Address - Street 2:
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-3468
Practice Address - Country:US
Practice Address - Phone:641-228-6344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02444225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist