Doctor Name: | MR. EDWARD JOSEPH LOFTUS |
NPI Number: | 1164614806 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.A. LLP. |
License Number: | 6301006424 |
Business Practice Address: | 50 Filer St Suite 210-e Manistee, MI - 496602726 |
Business Phone Number: | 2313980349 |
Business Fax Number: | 2317235870 |
Mailing Address: | 50 Filer St, Suite 210-e MANISTEE |
State: | MI |
Postal Code: | 496602726 |
Phone Number: | 2313980349 |
Fax Number: | 2317235870 |
NPI Enumeration Date: | 08/16/2007 |
NPI Last Update Date: | 08/16/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 6301006424 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |