Provider Demographics
NPI:1942260724
Name:LOVE, ROBERT A (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:LOVE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:143 N SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-2645
Mailing Address - Country:US
Mailing Address - Phone:937-778-4000
Mailing Address - Fax:937-778-4031
Practice Address - Street 1:143 N SUNSET DR
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-2645
Practice Address - Country:US
Practice Address - Phone:937-778-4000
Practice Address - Fax:937-778-4031
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-24
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2695111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2072975Medicaid
OH0859061Medicare PIN
OHU72971Medicare UPIN