Provider Demographics
NPI:1730902651
Name:PRO PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:PRO PHYSICAL THERAPY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:NAMIKO
Authorized Official - Last Name:LOFFER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:541-218-5309
Mailing Address - Street 1:1462 DARNEILLE LN
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-6309
Mailing Address - Country:US
Mailing Address - Phone:541-218-5309
Mailing Address - Fax:
Practice Address - Street 1:137 NE MILL STREET
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-6309
Practice Address - Country:US
Practice Address - Phone:541-218-5309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty