Provider Demographics
NPI:1932645249
Name:LOVSE, SARA (ATC)
Entity Type:Individual
Prefix:MISS
First Name:SARA
Middle Name:
Last Name:LOVSE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16490 DAWN DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1938
Mailing Address - Country:US
Mailing Address - Phone:586-764-6451
Mailing Address - Fax:
Practice Address - Street 1:609 E REDWOOD ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5163
Practice Address - Country:US
Practice Address - Phone:586-764-6451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-10
Last Update Date:2017-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program