Provider Demographics
NPI:1568494110
Name:LOVELL, RICHARD ALLEN (DC)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ALLEN
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 1:13427 FISHER RD
Mailing Address - Street 2:
Mailing Address - City:BURTON
Mailing Address - State:OH
Mailing Address - Zip Code:44021-9520
Mailing Address - Country:US
Mailing Address - Phone:440-834-9474
Mailing Address - Fax:440-834-9495
Practice Address - Street 1:13427 FISHER RD
Practice Address - Street 2:
Practice Address - City:BURTON
Practice Address - State:OH
Practice Address - Zip Code:44021-9520
Practice Address - Country:US
Practice Address - Phone:440-834-9474
Practice Address - Fax:440-834-9495
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH971111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH29452539900OtherBWC
OHLO0544542Medicare ID - Type Unspecified