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General NPI Number Information
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NPI Number | 1932507100
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Entity Type | Individual
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Provider Name | JASON LOVELESS P.T., D.P.T., NCS
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Gender | Male
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/14/2025
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Provider Practice Location Address
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Address Line | 912 S WASHINGTON AVE
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City | EMMETT
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State | ID
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Zip | 83617-3501
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Country | US
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Telephone | 208-365-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 912 S WASHINGTON AVE
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City | EMMETT
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State | ID
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Zip | 83617-3501
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Country | US
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Telephone | 208-365-4400
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7071991
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 2251N0400X
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Taxonomy Name | Neurology Physical Therapist
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License Number | 10077818-2401
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 41923
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License Number State | CA
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