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Individual

MR. JOHNNY DALE LOVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
2017 STONEBROOK PLACE, FRONTIER HEALTH FRONTIER INDUSTRIES, KINGSPORT, TN 37660
(423) 224-1412
(423) 224-1418
Mailing address
PO BOX 9054, GRAY, TN 37615-9054
(423) 467-3600
(423) 467-3644

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Enumeration date
03/20/2007
Last updated
07/08/2007
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