Provider Demographics
NPI:1598106122
Name:LOVELESS, KRISTINE M (PT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:M
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 OAK CENTRE DR
Mailing Address - Street 2:#450
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-3944
Mailing Address - Country:US
Mailing Address - Phone:210-297-4525
Mailing Address - Fax:210-297-0459
Practice Address - Street 1:525 OAK CENTRE DR
Practice Address - Street 2:#450
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3944
Practice Address - Country:US
Practice Address - Phone:210-297-4525
Practice Address - Fax:210-297-0459
Is Sole Proprietor?:No
Enumeration Date:2013-07-11
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1152692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist