Provider Demographics
NPI:1457029472
Name:LOVE DERMATOLOGY & AESTHETICS, LLC
Entity Type:Organization
Organization Name:LOVE DERMATOLOGY & AESTHETICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:J
Authorized Official - Last Name:BREEDLOVE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:614-401-2208
Mailing Address - Street 1:6215 EMERALD PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-3315
Mailing Address - Country:US
Mailing Address - Phone:614-401-2208
Mailing Address - Fax:440-596-4905
Practice Address - Street 1:6215 EMERALD PKWY STE 2
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3315
Practice Address - Country:US
Practice Address - Phone:614-401-2208
Practice Address - Fax:440-596-4905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty