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Contact Information

STEPHANE PROVENCHER, D.C.
8006 CRESCENT PARK DR
GAINESVILLE, VA20155
 Phone: 571-248-0695
 Fax: 571-248-0964
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Chiropractor

111N00000X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for STEPHANE PROVENCHER · (Male)

NPI Number 1376729376
Status Active
Credentials D.C. (Doctor of Chiropractic)
Entity Individual
Enumeration date 01/21/2008
Last updated 06/11/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • MO License # 2008001511
  • VA License # 0104556839
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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