Provider Demographics
NPI:1881113017
Name:LOEFFELHOLZ, KATE ANNE (PTA, ATC)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:ANNE
Last Name:LOEFFELHOLZ
Suffix:
Gender:F
Credentials:PTA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 KEOKUK ST
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52001-1704
Mailing Address - Country:US
Mailing Address - Phone:563-880-7789
Mailing Address - Fax:
Practice Address - Street 1:3180 KEOKUK ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-1704
Practice Address - Country:US
Practice Address - Phone:563-880-7789
Practice Address - Fax:563-880-7789
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0752102255A2300X
IA098876225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Multi-Specialty