Basic Information
| Provider Information | |||||||||
| NPI: | 1295049633 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LOOMIS | ||||||||
| FirstName: | DAWN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4214 NORTH ROXBORO ST | ||||||||
| Address2: | #100 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277041826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194799001 | ||||||||
| FaxNumber: | 9194799003 | ||||||||
| Practice Location | |||||||||
| Address1: | 4214 NORTH ROXBORO ST | ||||||||
| Address2: | #100 | ||||||||
| City: | DURHAM | ||||||||
| State: | NC | ||||||||
| PostalCode: | 277041826 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9194799001 | ||||||||
| FaxNumber: | 9194799003 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2010 | ||||||||
| LastUpdateDate: | 03/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | P12742 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.