MEDICARE: DR. GARY ALLEN LOVE D.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	111NX0800X	Orthopedic Chiropractor	2056	AZ

General Provider Information

NPI Number	:	1699852434
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY ALLEN LOVE D.C.

Provider Business Mailing Address
First Line	:	2828 E FORT LOWELL RD
Second Line	:	BLDG. A
City	:	TUCSON
State	:	AZ
Zip	:	85716-1518
Country	:	US
Telephone Number	:	520-326-5543
Fax Number	:	520-323-8765

Provider Business Practice Location Address
First Line	:	2828 E FORT LOWELL RD
Second Line	:	BLDG. A
City	:	TUCSON
State	:	AZ
Zip	:	85716-1518
Country	:	US
Telephone Number	:	520-326-5543
Fax Number	:	520-323-8765

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/08/2007

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