Individual
MR. MICHAEL SHANE LOVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C-EP
Contact information
Practice address
957 NATIONAL HWY, LAVALE, MD 21502-7356
(301) 729-9475
Mailing address
957 NATIONAL HWY, LAVALE MD 21502, LAVALE, MD 21502
(307) 729-9475
(301) 729-9474
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
Primary
1024667
—
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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