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Individual
MR. RANDALL S LOFGREN
Active
Individual
MR. RANDALL S LOFGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT015022
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA9531
RAILROAD MEDICARE
PA
01
—
P00276445
RAILROAD MEDICARE
PA
Enumeration date
09/21/2005
Last updated
04/02/2008
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