Healthcare Provider Details
I. General information
NPI: 1851447197
Provider Name (Legal Business Name): MRS. CATHY LOVETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/27/2007
Last Update Date: 01/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6322 SWAMP FOX HWY W
TABOR CITY NC
28463-8624
US
IV. Provider business mailing address
6322 SWAMP FOX HWY W
TABOR CITY NC
28463-8624
US
V. Phone/Fax
- Phone: 910-653-9314
- Fax: 910-653-9314
- Phone: 910-653-9314
- Fax: 910-653-9314
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | 00014 |
| License Number State | NC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: