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Stephane Provencher Llc
Chiropractor in Gainesville, Virginia
NPI 1578960340

Stephane Provencher Llc is a Chiropractor based in Gainesville, VA. Stephane Provencher Llc practices in Gainesville, VA. The NPI Number for Stephane Provencher Llc is 1578960340 and holds a License No. 0104556839 (Virginia).

The current practice location address for Stephane Provencher Llc is 8006 Crescent Park Dr, Gainesville, VA and can be reached out via phone at 571-248-0695 and via fax at 571-248-0964.

Location: 8006 Crescent Park Dr, Gainesville, VA, 20155-3444
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1578960340
Provider Name
Stephane Provencher Llc
Credential
Provider Entity Type
Organization
Address
8006 Crescent Park Dr, Gainesville, VA, 20155-3444
Phone Number
571-248-0695
Fax Number
571-248-0964
Provider Enumeration Date
11/22/2014
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
VVB2500281 01 VA MEDICARE PTAN
institution
Provider Business Practice Location Address Details
Address
8006 Crescent Park Dr
City
Gainesville
State
Virginia
Zip
20155-3444
Phone Number
571-248-0695
Fax Number
571-248-0964
person
Provider Business Mailing Address Details
Address
8006 Crescent Park Dr
City
Gainesville
State
Virginia
Zip
20155-3444
Phone Number
571-248-0695
Fax Number
571-248-0964
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
0104556839 (Virginia)
Definition
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.
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