Provider Demographics
NPI:1972963734
Name:LOFLIN-FANN, ASHLEY M (DPT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:LOFLIN-FANN
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:M
Other - Last Name:FANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:411 BURNAGE WAY
Mailing Address - Street 2:APR. 307
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7847
Mailing Address - Country:US
Mailing Address - Phone:256-509-4154
Mailing Address - Fax:
Practice Address - Street 1:1317 EBENEZER RD
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2336
Practice Address - Country:US
Practice Address - Phone:803-207-8177
Practice Address - Fax:803-207-8130
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7463225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist