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General NPI Number Information
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NPI Number | 1326719022
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Entity Type | Individual
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Provider Name | DERIC VICTOR LOVETT DC
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Gender | Male
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 09/22/2021
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Provider Practice Location Address
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Address Line | 1528 LAKEVIEW RD STE 150
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City | CLEARWATER
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State | FL
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Zip | 33756-3648
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Country | US
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Telephone | 727-408-5222
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Fax |
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Provider Business Mailing Address
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Address Line | 8675 29TH WAY N APT 303
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City | PINELLAS PARK
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State | FL
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Zip | 33782-6224
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Country | US
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Telephone | 954-895-5233
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13681
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License Number State | FL
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