Healthcare Provider Details

I. General information

NPI: 1174876122
Provider Name (Legal Business Name): THE LOVELACE INSTITUTE FOR SPINE & SPORTS INJURIES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 10/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PORTWALK PLACE
PORTSMOUTH NH
03801
US

IV. Provider business mailing address

PO BOX 196
ALTON BAY NH
03810-0196
US

V. Phone/Fax

Practice location:
  • Phone: 603-630-2229
  • Fax:
Mailing address:
  • Phone: 603-630-2229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number894
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number894
License Number StateNH

VIII. Authorized Official

Name: DR. TAMARA LEA LOVELACE
Title or Position: PRESIDENT / CLINIC DIRECTOR
Credential: DC, DACBSP
Phone: 603-630-2229