Provider Demographics
NPI:1699896811
Name:LOJA-RAMISCAL, GEMMARIE TUPAZ (PT, DPT)
Entity type:Individual
Prefix:MRS
First Name:GEMMARIE
Middle Name:TUPAZ
Last Name:LOJA-RAMISCAL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:GEMMARIE
Other - Middle Name:TUPAZ
Other - Last Name:LOJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1305 D'ANTIGNAC ST
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-2774
Mailing Address - Country:US
Mailing Address - Phone:706-922-6561
Mailing Address - Fax:706-823-3810
Practice Address - Street 1:1305 D'ANTIGNAC ST
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-2774
Practice Address - Country:US
Practice Address - Phone:706-922-6561
Practice Address - Fax:706-823-3810
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA0094300225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist