Provider Demographics
NPI:1033207592
Name:LOVE, ROY MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:MICHAEL
Last Name:LOVE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 UNIVERSITY DRIVE
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801
Mailing Address - Country:US
Mailing Address - Phone:814-234-5271
Mailing Address - Fax:814-234-9730
Practice Address - Street 1:611 UNIVERSITY DRIVE
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801
Practice Address - Country:US
Practice Address - Phone:814-234-5271
Practice Address - Fax:814-234-9730
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC3147-L111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PALO1592TPUMedicare ID - Type Unspecified
PA087053Medicare ID - Type UnspecifiedGROUP NUMBER