Basic Information
Provider Information
NPI: 1316901713
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LOVERING PAGE
FirstName: APRIL
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PT, DPT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 69030
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212649030
CountryCode: US
TelephoneNumber: 7578732302
FaxNumber: 7578732306
Practice Location
Address1: 300B TEMPLE LAKE DR STE 1
Address2:  
City: COLONIAL HEIGHTS
State: VA
PostalCode: 238342973
CountryCode: US
TelephoneNumber: 8045249036
FaxNumber: 8045249039
Other Information
ProviderEnumerationDate: 04/13/2006
LastUpdateDate: 04/25/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X2305001774VAY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

ID Information
IDTypeStateIssuerDescription
01021729605VA MEDICAID
787975801VAAETNAOTHER
P0038120101VARAILROAD MEDICAREOTHER
19294601VABCBS (PT)OTHER


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