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Individual

MICHAEL CHARLES LOFBOOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
155 RADIO DR, WOODBURY, MN 55125-2619
(952) 831-8742
Mailing address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(888) 873-4221

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11449
MN

Other

Enumeration date
06/10/2019
Last updated
07/17/2019
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