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Individual

CARRIE ANN LOOMIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, MPT

Contact information

Practice address
1630 RIDGEWAY ST, OCEANSIDE, CA 92054-5637
(760) 688-9089
Mailing address
403 ALI WAY, FALLBROOK, CA 92028-3900
(760) 535-9815

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT24870
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0PT248700
BLUE SHIELD
CA
01
P01453018
RR MEDICARE
CA
Enumeration date
12/07/2005
Last updated
09/07/2023
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