Provider Demographics
NPI:1891070033
Name:LOVE, ALEXANDER (LAC)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:
Last Name:LOVE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 30TH ST
Mailing Address - Street 2:STE 310
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80301-1088
Mailing Address - Country:US
Mailing Address - Phone:303-947-1315
Mailing Address - Fax:
Practice Address - Street 1:1800 30TH ST
Practice Address - Street 2:STE 310
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80301-1088
Practice Address - Country:US
Practice Address - Phone:303-947-1315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-19
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1013171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist