Individual
CASEY RAY LOVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3600 NW SAMARITAN DR, CORVALLIS, OR 97330-5472
(541) 768-4906
Mailing address
112 E BOURNE ST, DURANT, OK 74701-8601
(662) 542-5394
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
PG211170
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
06/17/2021
Last updated
04/21/2022
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