Individual
TREVOR WAYNE LOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2211 E CLAIBORNE ST, SPRINGFIELD, MO 65804-3823
(417) 569-9808
Mailing address
2211 E CLAIBORNE ST, SPRINGFIELD, MO 65804-3823
(417) 569-9808
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2018026147
MO
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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