Provider Demographics
NPI:1902863988
Name:LOFTUS, DEBORAH K (PT, OCS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:K
Last Name:LOFTUS
Suffix:
Gender:F
Credentials:PT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W156N11072 PILGRIM RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53022-4247
Mailing Address - Country:US
Mailing Address - Phone:262-251-0340
Mailing Address - Fax:262-502-1384
Practice Address - Street 1:W156N11072 PILGRIM RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:WI
Practice Address - Zip Code:53022-4247
Practice Address - Country:US
Practice Address - Phone:262-251-0340
Practice Address - Fax:262-502-1384
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2597-0242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40184200Medicaid
WI2597-024OtherPT LICENSE #
WI40184200Medicaid