Provider Demographics
NPI:1578631594
Name:RALPH L. LOVE D.C., P.C.
Entity Type:Organization
Organization Name:RALPH L. LOVE D.C., P.C.
Other - Org Name:LOVE CHIROPRACTIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DON
Authorized Official - Middle Name:TYLER
Authorized Official - Last Name:HANDLY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:276-647-3728
Mailing Address - Street 1:5140 KINGS MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24078-1828
Mailing Address - Country:US
Mailing Address - Phone:276-647-3728
Mailing Address - Fax:276-647-3739
Practice Address - Street 1:5140 KINGS MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24078-1828
Practice Address - Country:US
Practice Address - Phone:276-647-3728
Practice Address - Fax:276-647-3739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAT01619Medicare UPIN