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Contact Information

GERRY G PROVANCE, D.C.
2007 CLEARVIEW PKWY
METAIRIE, LA70001-2404
 Phone: 504-456-9296
 Fax: 504-456-9799
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for GERRY G PROVANCE · (Male)

NPI # 1063555662
Status Active
Credentials D.C. (Doctor of Chiropractic)
Entity Individual
Enumeration date 02/14/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • LA License # 414
  • LA Medicaid 1951340
  • LA Other C8327 BLUE CROSS ID
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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