Provider Demographics
NPI:1811502651
Name:LOVELL, SUMMER N
Entity type:Individual
Prefix:
First Name:SUMMER
Middle Name:N
Last Name:LOVELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SUMMER
Other - Middle Name:
Other - Last Name:ARMSTRONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1218 STONE ST STE 140
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-4568
Mailing Address - Country:US
Mailing Address - Phone:870-336-0220
Mailing Address - Fax:870-558-5637
Practice Address - Street 1:1218 STONE ST STE 140
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4568
Practice Address - Country:US
Practice Address - Phone:870-336-0220
Practice Address - Fax:870-558-5637
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
4546225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty