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Individual

JORDAN TIMOTHY LOVELACE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
880 S MOHAWK DR, ERWIN, TN 37650-2125
(423) 743-7669
Mailing address
508 MITCHELL RD, KINGSPORT, TN 37663-3238
(276) 701-6764

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
0000006751
TN

Other

Enumeration date
05/20/2021
Last updated
05/20/2021
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