Provider Demographics
NPI:1306099353
Name:LOVE, STEPHEN (DC)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:LOVE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5227 US HIGHWAY 98 S
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33812
Mailing Address - Country:US
Mailing Address - Phone:863-709-1600
Mailing Address - Fax:863-709-1616
Practice Address - Street 1:2390 GRIFFIN ROAD
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33841-4182
Practice Address - Country:US
Practice Address - Phone:863-859-0335
Practice Address - Fax:863-859-0501
Is Sole Proprietor?:No
Enumeration Date:2008-11-03
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor