Gerry G Provance
Chiropractic Sports Physician
2007 Clearview Pkwy
Metairie
, Louisiana 70001-2404
Gerry G Provance
Chiropractic Sports Physician
2007 Clearview Pkwy
Metairie
, Louisiana 70001-2404
(504) 456-9799
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Gerry G Provance
- 2007 Clearview Pkwy
- Metairie, LA
- Zip : 70001-2404
- Fax : (504) 456-9799
- Phone : (504) 456-9296
Second Address
- Gerry G Provance
- 2007 Clearview Pkwy
- Metairie, LA
- Zip : 70001-2404
- Fax : (504) 456-9799
- Phone : (504) 456-9296
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | 414 | LA |
National Provider Identifier
| NPI | 1063555662 |
|---|---|
| Provider Name | Gerry G Provance |
| First Address | Metairie, LA 70001-2404 |
| Second Address | Metairie, LA 70001-2404 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 14/02/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1951340 | (05) | LA |
| C8327 | BLUE CROSS ID (01) | LA |
| T19890 | (02) | LA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.