Healthcare Provider Details

I. General information

NPI: 1891168233
Provider Name (Legal Business Name): MICHAEL LOVICH D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PORTWALK PL
PORTSMOUTH NH
03801-4086
US

IV. Provider business mailing address

12 PORTWALK PL
PORTSMOUTH NH
03801-4086
US

V. Phone/Fax

Practice location:
  • Phone: 603-431-4200
  • Fax: 603-431-4202
Mailing address:
  • Phone: 603-431-4200
  • Fax: 603-431-4202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number981
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: