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Individual

MS. ELLEN W. LOAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
1837 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 292-4217
(855) 840-8203
Mailing address
1837 NEBRASKA AVE, GRANTS PASS, OR 97527-5701
(541) 292-4244
(855) 840-8203

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2606
AR
225100000X
Physical Therapist
Primary
63340
OR
225100000X
Physical Therapist
PT60685784
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146698721
AR
Enumeration date
12/06/2005
Last updated
10/21/2020
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