Provider Demographics
NPI:1740582626
Name:LOVETT, LEONARD JR (LMT,)
Entity Type:Individual
Prefix:MR
First Name:LEONARD
Middle Name:
Last Name:LOVETT
Suffix:JR
Gender:M
Credentials:LMT,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 SOUTH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06706-1789
Mailing Address - Country:US
Mailing Address - Phone:475-689-8324
Mailing Address - Fax:
Practice Address - Street 1:93 MERIDEN RD
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06705-1933
Practice Address - Country:US
Practice Address - Phone:475-689-8324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL#MA54724225700000X
CT10652225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist