Provider Demographics
NPI:1356428312
Name:LOVE, WILLIAM BERNARD (LPTA)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:BERNARD
Last Name:LOVE
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2908 RANNOCK CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-3533
Mailing Address - Country:US
Mailing Address - Phone:919-876-5536
Mailing Address - Fax:919-872-1913
Practice Address - Street 1:820 S BOYLON AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-2176
Practice Address - Country:US
Practice Address - Phone:919-733-5576
Practice Address - Fax:919-733-7365
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0056225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant