Provider Demographics
NPI:1710301627
Name:LOVE, WHITNEY (ATC, LAT)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:
Last Name:LOVE
Suffix:
Gender:F
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 GUNNISON AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-2628
Mailing Address - Country:US
Mailing Address - Phone:970-260-2889
Mailing Address - Fax:
Practice Address - Street 1:2201 SILVER LAKE RD
Practice Address - Street 2:167
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-6233
Practice Address - Country:US
Practice Address - Phone:970-260-2889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS20000112842255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer