STEPHANE PROVENCHER LLC NPI 1578960340

NPI Information

STEPHANE PROVENCHER LLC is a chiropractor in Gainesville, VA. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. STEPHANE PROVENCHER LLC NPI is 1578960340. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Gainesville Holistic Health Center.

The provider's business location address is:

8006 CRESCENT PARK DR
GAINESVILLE, VA
ZIP 20155-444
Phone: (571) 248-0695
Fax: (571) 248-0964

The provider's authorized official is Stephane Provencher .
The authorized official title is Owner and has the following contact phone number (571) 248-0695.

The enumeration date for this NPI number is 11/22/2014 and was last updated on 11/22/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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