Individual
DIANE LOFTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3956 17TH ST, ECORSE, MI 48229-1310
(313) 983-9212
Mailing address
3956 17TH ST, ECORSE, MI 48229-1310
(313) 983-9212
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703100641
MI
Other
Enumeration date
04/09/2018
Last updated
04/09/2018
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