Provider Demographics
NPI:1891574497
Name:LOVE, JANEL ELAINE (PTA)
Entity Type:Individual
Prefix:
First Name:JANEL
Middle Name:ELAINE
Last Name:LOVE
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11834 KENNINGTON SQ E
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8561
Mailing Address - Country:US
Mailing Address - Phone:808-343-8303
Mailing Address - Fax:
Practice Address - Street 1:402 LIBERTY WAY
Practice Address - Street 2:
Practice Address - City:GAHANNA
Practice Address - State:OH
Practice Address - Zip Code:43230-3502
Practice Address - Country:US
Practice Address - Phone:614-831-2600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA013668225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant