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1790406122
RAVEN LOFTUS
WHITING, NJ
NPI
1790406122
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Former Name
RAVEN THOMAS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40QA02112800)
Enumeration Date
2022-09-05
Last Update Date
2023-08-16
Business Address
RAVEN LOFTUS PT, DPT
63 LACEY RD STE H
WHITING, NJ 08759-2966
Phone number: 732-716-0111
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Mailing Address
RAVEN LOFTUS PT, DPT
11 EAGLE ROCK AVE STE 201
EAST HANOVER, NJ 07936-3167
Phone number: 973-887-9000
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