Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | DC3147-L | PA |
NPI | 1033207592 |
---|---|
Provider Name | Dr. Roy Michael Love |
First Address | State College, PA 16801 |
Second Address | State College, PA 16801 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |