Provider Demographics
NPI:1568674646
Name:LOVETT, JAMES WILLIAM
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:WILLIAM
Last Name:LOVETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 3RD AVE SE
Mailing Address - Street 2:STE: 206
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55904-4619
Mailing Address - Country:US
Mailing Address - Phone:507-252-5448
Mailing Address - Fax:
Practice Address - Street 1:300 3RD AVE SE
Practice Address - Street 2:STE:206
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-252-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2889111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN350001368Medicare PIN