Individual
BRANDON LOVELESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L , CPED
Contact information
Practice address
4400 SW 21ST ST, OKLAHOMA CITY, OK 73108-1747
(405) 681-4082
Mailing address
4400 SW 21ST ST, OKLAHOMA CITY, OK 73108-1747
(405) 681-4082
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1228
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
412176589
FED TAX ID
—
Enumeration date
08/11/2006
Last updated
03/11/2019
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