Provider Demographics
NPI:1225796576
Name:LOVING, ANNALEE RAVEN (PT)
Entity Type:Individual
Prefix:
First Name:ANNALEE
Middle Name:RAVEN
Last Name:LOVING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:9832 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:VA
Mailing Address - Zip Code:22503-3900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 IRVINGTON RD # 128
Practice Address - Street 2:
Practice Address - City:KILMARNOCK
Practice Address - State:VA
Practice Address - Zip Code:22482-9590
Practice Address - Country:US
Practice Address - Phone:804-435-3435
Practice Address - Fax:804-435-3682
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305214790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist