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General NPI Number Information
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NPI Number | 1417928342
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Entity Type | Individual
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Provider Name | TRACY OLIVER LOVETT RPT
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Gender | Female
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 101 FAIRVIEW PARK DR
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City | DUBLIN
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State | GA
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Zip | 31021-2501
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Country | US
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Telephone | 478-272-7494
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Fax | 478-272-2616
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Provider Business Mailing Address
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Address Line | PO BOX 949
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City | ROME
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State | GA
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Zip | 30162-0949
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Country | US
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Telephone | 706-802-1991
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Fax | 706-802-1408
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1413
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License Number State | GA
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