Provider Demographics
NPI:1215813969
Name:LOVE, MYRON NEAL JR
Entity type:Individual
Prefix:MR
First Name:MYRON
Middle Name:NEAL
Last Name:LOVE
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7417 INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1909
Mailing Address - Country:US
Mailing Address - Phone:816-590-6982
Mailing Address - Fax:
Practice Address - Street 1:8301 STATE LINE RD # 220
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2025
Practice Address - Country:US
Practice Address - Phone:816-768-4788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-15
Last Update Date:2025-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOV203117012343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)