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NPI Code Detail

MEDICARE: CLAIRE MARTINE LOVE

MEDICARE: CLAIRE MARTINE LOVE
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1861157315
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLAIRE MARTINE LOVE
Provider Business Mailing Address
First Line : 3701 LINDELL BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-3425
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3701 LINDELL BLVD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-3425
Country : US
Telephone Number : 708-657-6868
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2021
Last Update Date : 11/01/2021

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Directions to “ CLAIRE MARTINE LOVE ” Practice Location

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