Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT60113876 | WA |
N | 2251S0007X | Physical Therapist - Sports | PT60113876 | WA |
NPI | 1386978948 |
---|---|
Provider Name | Michael J. Loforti |
First Address | Fircrest, WA 98466-6606 |
Second Address | Tacoma, WA 98444-1858 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2009 |
Last Update Date | 02/04/2021 |