Healthcare Provider Details
I. General information
NPI: 1952303174
Provider Name (Legal Business Name): MICHAEL LOVE ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2005
Last Update Date: 07/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8388 LEWISTON RD
BATAVIA NY
14020-1243
US
IV. Provider business mailing address
8388 LEWISTON RD
BATAVIA NY
14020-1243
US
V. Phone/Fax
- Phone: 585-343-4154
- Fax: 585-343-8101
- Phone: 585-343-4154
- Fax: 585-343-8101
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | NOT NECESSARY |
| License Number State | NY |
VIII. Authorized Official
Name: MRS.
LEE
ANN
PATTERSON
Title or Position: CORPORATE VICE-PRESIDENT
Credential:
Phone: 585-343-4154