Provider Demographics
NPI:1235752247
Name:LOVELADY, RACHEL (MPT)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:LOVELADY
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MARLOW
Mailing Address - State:OK
Mailing Address - Zip Code:73055-2439
Mailing Address - Country:US
Mailing Address - Phone:580-695-3084
Mailing Address - Fax:
Practice Address - Street 1:231 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLOW
Practice Address - State:OK
Practice Address - Zip Code:73055-2439
Practice Address - Country:US
Practice Address - Phone:580-721-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-26
Last Update Date:2020-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3822225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist