Organization
ZENLO DERMATOLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAREN ROYAL LOVE (PRESIDEDNT)
(804) 934-0060
Entity
Organization
Contact information
Practice address
10120 W BROAD ST, SUITE R, GLEN ALLEN, VA 23060-6709
(804) 934-0060
(804) 934-0024
Mailing address
10120 W BROAD ST, SUITE R, GLEN ALLEN, VA 23060-6709
(804) 934-0060
(804) 934-0024
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
0101051656
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
183408
ANTHEM
VA
01
—
DD7147
MEDICARE/ RAILROAD
VA
Enumeration date
11/28/2007
Last updated
12/04/2007
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