Provider Demographics
NPI:1477686467
Name:LOVELL, NORMAN TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:TODD
Last Name:LOVELL
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 1:570 RIVERSTONE WAY
Mailing Address - Street 2:STE. #2
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99709-2939
Mailing Address - Country:US
Mailing Address - Phone:907-458-8633
Mailing Address - Fax:907-458-8622
Practice Address - Street 1:570 RIVERSTONE WAY
Practice Address - Street 2:SUITE #2
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99709-2939
Practice Address - Country:US
Practice Address - Phone:907-458-8633
Practice Address - Fax:907-458-8622
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCH03171Medicaid
AKU65360Medicare UPIN
AKCH03171Medicaid