Dr. Michael L Provenzano, DC, DPT
Physical Therapist in Andover, Massachusetts
1225157423- Practice location
- 16 Haverhill St, Andover, MA 01810-3002
- Phone
- 978-470-1499
- Fax
- 978-470-1408
- Last updated
- December 17, 2025
Michael Louis Provenzano is a Physical Therapist based in Andover, MA. Michael Louis Provenzano practices in Andover, MA and has the professional credentials of DC, DPT. The NPI Number for Michael Louis Provenzano is 1225157423 and holds a License No. 18057 (MA). The current practice location address for Michael Louis Provenzano is 16 Haverhill St, Andover, MA 01810-3002 and can be reached out via phone at 978-470-1499 and via fax at 978-470-1408.
Provider Profile Details
- NPI Number
- 1225157423
- Provider Name
- Michael Louis Provenzano
- Credential
- DC, DPT
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 16 Haverhill St, Andover, MA 01810-3002
- Phone Number
- 978-470-1499
- Fax Number
- 978-470-1408
- Primary Taxonomy
- Physical Therapist · 225100000X
- Sole Proprietor
- No
- Other Names
- Dr. Michael Louis Provenzano, DC, DPT (Former Name)
- Provider Enumeration Date
- March 28, 2007
- Last Update Date
- December 17, 2025
- Certification Date
- December 17, 2025
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 16 Haverhill St
Andover, MA 01810-3002 - City
- Andover
- State
- Massachusetts
- Zip
- 01810-3002
- Phone Number
- 978-470-1499
- Fax Number
- 978-470-1408
Provider Business Mailing Address Details
- Address
- 16 Haverhill St
Andover, MA 01810-3002 - City
- Andover
- State
- MA
- Zip
- 01810-3002
- Phone Number
- 978-470-1499
- Fax Number
- 978-470-1408
License Information
- License Number (1)
- 18057
- License State (1)
- MA
- Taxonomy (1)
- Physical Therapist · 225100000X · Primary
- License Number (2)
- 2154
- License State (2)
- MA
- Taxonomy (2)
- Chiropractor · 111N00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Dr. Michael L Provenzano, DC, DPT?
The NPI number of Dr. Michael L Provenzano, DC, DPT is 1225157423. It was assigned on March 28, 2007 and is currently active in the NPPES registry.
What is the specialty of Dr. Michael L Provenzano, DC, DPT?
Dr. Michael L Provenzano, DC, DPT is registered under the primary taxonomy Physical Therapist (code 225100000X), licensed in MA under license number 18057.
Where does Dr. Michael L Provenzano, DC, DPT practice?
The practice location is 16 Haverhill St, Andover, MA 01810-3002. The office can be reached at 978-470-1499 (phone) or 978-470-1408 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1225157423 directly on the NPPES registry website.