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Individual

SHARON LOFTUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MT

Contact information

Practice address
N63W23524 SILVER SPRING DR # 4, SUSSEX, WI 53089-3833
(262) 246-8410
(262) 246-8894
Mailing address
N63W23524 SILVER SPRING DR # 4, SUSSEX, WI 53089-3833
(262) 246-8410
(262) 246-8894

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1003046
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1003046
STATE LICENSE
WI
01
27929900
NATIONAL CERTIFICATION BOARD #
WI
Enumeration date
05/08/2008
Last updated
05/08/2008
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