Individual
MR. KIERAN PAUL LOVING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
12731 MARBLESTONE DR, WOODBRIDGE, VA 22192-8333
(571) 659-2612
Mailing address
11992 MOLLY PITCHER CIR, MANASSAS, VA 20109-4800
(703) 505-0643
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001259
VA
2255A2300X
Athletic Trainer
AT8506
TX
Other
Enumeration date
04/28/2021
Last updated
04/28/2021
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