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MR. JACOB LOVELESS
>> Organized Health Care Education/Training Program >> StudentRegistrant NPI Number: 1407219207
Individual Registrant:MR. JACOB LOVELESS
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
8216 M.5 RD GLADSTONE, MI 49837-9078 US
Tel: 906-399-9928 Fax: --
Tel: 906-399-9928 Fax: --
Contact information for business:
8216 M.5 RD GLADSTONE, MI 49837-9078 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1407219207
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 390200000X | Student Organized Health Care Education/Training Program | MI |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
