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Organization

ZEN LO DERMATOLOGY, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KAREN ROYAL LOVE (PRESIDENT)
(804) 934-0060
Entity
Organization

Contact information

Practice address
10120 WEST BROAD STREET, SUITE R, GLEN ALLEN, VA 23060
(804) 934-0060
Mailing address
10120 WEST BROAD STREET, SUITE R, GLEN ALLEN, VA 23060
(804) 934-0060

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101051656
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
183408
ANTHEM
VA
01
C09951
MEDICARE GROUP
VA
01
DD7147
MEDICARE RAILROAD
VA
Enumeration date
11/30/2007
Last updated
11/30/2007
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