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General NPI Number Information
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NPI Number | 1851560825
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Entity Type | Organization
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Legal Business Name | LOVELESS ORTHOPEDIC APPLIANCE
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Dates
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Enumeration Date | 02/25/2008
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Last Update Date | 02/25/2008
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Provider Practice Location Address
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Address Line | 4400 SW 21ST ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73108-1747
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Country | US
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Telephone | 405-631-9731
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Fax | 405-634-9717
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Provider Business Mailing Address
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Address Line | 4400 SW 21ST ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73108-1747
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Country | US
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Telephone | 405-631-9731
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Fax | 405-634-9717
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GARY LOVELESS
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Credential | C.O., L.P.O.,LPED
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Telephone | 405-631-9731
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 31
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number | 23
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License Number State | OK
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