MEDICARE: RALPH L. LOVE D.C., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor		VA

General Provider Information

NPI Number	:	1578631594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RALPH L. LOVE D.C., P.C.

Provider Business Mailing Address
First Line	:	5140 KINGS MOUNTAIN RD
Second Line	:
City	:	COLLINSVILLE
State	:	VA
Zip	:	24078-1828
Country	:	US
Telephone Number	:	276-647-3728
Fax Number	:	276-647-3739

Provider Business Practice Location Address
First Line	:	5140 KINGS MOUNTAIN RD
Second Line	:
City	:	COLLINSVILLE
State	:	VA
Zip	:	24078-1828
Country	:	US
Telephone Number	:	276-647-3728
Fax Number	:	276-647-3739

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. DON TYLER HANDLY
Credential	:	D.C.
Telephone Number	:	276-647-3728

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	10/18/2007

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