Individual
MRS. LESLIE COLEMAN LOVELACE
Active
Individual
MRS. LESLIE COLEMAN LOVELACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305206355
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245562073
—
VA
01
—
2305206355
STATE OF VIRGINIA LICENSE
VA
Enumeration date
02/04/2010
Last updated
06/12/2020
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