Provider Demographics
NPI:1649972407
Name:LOVE, KIOSHI DEE (PT)
Entity type:Individual
Prefix:
First Name:KIOSHI
Middle Name:DEE
Last Name:LOVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:5125 OQUENDO RD
Mailing Address - Street 2:STE 12 PMB 1019
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118
Mailing Address - Country:US
Mailing Address - Phone:725-216-2333
Mailing Address - Fax:702-745-0948
Practice Address - Street 1:2301 REDWOOD ST APT 3806
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-0839
Practice Address - Country:US
Practice Address - Phone:323-590-8619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
246RP1900X
NVQ7K5E9W4246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy