Provider Demographics
NPI:1497294672
Name:LOVELY, SHERMIA
Entity Type:Individual
Prefix:
First Name:SHERMIA
Middle Name:
Last Name:LOVELY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15411 EDMORE DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-1350
Mailing Address - Country:US
Mailing Address - Phone:313-209-2081
Mailing Address - Fax:
Practice Address - Street 1:15411 EDMORE DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-1350
Practice Address - Country:US
Practice Address - Phone:313-209-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI111N0000X111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor