Healthcare Provider Details

I. General information

NPI: 1437127578
Provider Name (Legal Business Name): DANA D LOVE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SCOTTSVILLE RD SUITE 101
BOWLING GREEN KY
42104-3217
US

IV. Provider business mailing address

PO BOX 391
BOWLING GREEN KY
42102-0391
US

V. Phone/Fax

Practice location:
  • Phone: 270-781-0028
  • Fax: 270-781-0007
Mailing address:
  • Phone: 270-781-0028
  • Fax: 270-781-0007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number004454
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: