Provider Demographics
NPI:1316322597
Name:LOVEMARK, CARRIE (LAC)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:
Last Name:LOVEMARK
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:DAYS CREEK
Mailing Address - State:OR
Mailing Address - Zip Code:97429
Mailing Address - Country:US
Mailing Address - Phone:541-517-9869
Mailing Address - Fax:541-543-2220
Practice Address - Street 1:213 S. OLD PACIFIC HWY, SUITE #100
Practice Address - Street 2:
Practice Address - City:MYRTLE CREEK
Practice Address - State:OR
Practice Address - Zip Code:97457
Practice Address - Country:US
Practice Address - Phone:541-860-1515
Practice Address - Fax:541-543-2220
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-29
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR172295171100000X
ORAC172295171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist