Provider Demographics
NPI:1245244748
Name:LOVE, DAVID ALEXANDER (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ALEXANDER
Last Name:LOVE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:SOUTH HILL
Mailing Address - State:VA
Mailing Address - Zip Code:23970-0217
Mailing Address - Country:US
Mailing Address - Phone:434-447-3322
Mailing Address - Fax:
Practice Address - Street 1:1187 NORTH MECKLENBURG AVE.
Practice Address - Street 2:
Practice Address - City:LACROSSE
Practice Address - State:VA
Practice Address - Zip Code:23950
Practice Address - Country:US
Practice Address - Phone:434-447-3322
Practice Address - Fax:434-447-3282
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23050065332251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00080648OtherRR MEDICARE ID
P00080648OtherRR MEDICARE ID