Provider Demographics
NPI:1306943014
Name:LOILAND, ERIC AANUND (DPT DOCTOR OF PHYSIC)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:AANUND
Last Name:LOILAND
Suffix:
Gender:M
Credentials:DPT DOCTOR OF PHYSIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4434
Mailing Address - Country:US
Mailing Address - Phone:602-745-2948
Mailing Address - Fax:602-745-2962
Practice Address - Street 1:3090 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4402
Practice Address - Country:US
Practice Address - Phone:602-745-2930
Practice Address - Fax:602-745-2963
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPT-007283225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ221203Medicaid
AZ221203Medicaid