Individual
DOREEN LOOMIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4851 2ND ST NE, FRIDLEY, MN 55421-2124
(320) 293-6116
(320) 210-0438
Mailing address
4851 2ND ST NE, FRIDLEY, MN 55421-2124
(320) 293-6116
(320) 210-0438
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
172A00000X
Driver
—
—
Other
Enumeration date
06/25/2015
Last updated
06/25/2015
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