Provance Chiropractic Sport, Family & Rehab

NPI #1790917490 in Metairie, Louisiana

Provider Information

NPI Number: 1790917490
Entity Type: Organization
Organization Name: Provance Chiropractic Sport, Family & Rehab
Primary Specialty: Chiropractor
Enumeration Date: Aug 13, 2009
Last Updated: May 15, 2015

Practice Location

Address: 2007 CLEARVIEW PKWY
City: Metairie
State: Louisiana
ZIP Code: 70001-2404
Phone: (504) 456-9296

Authorized Official

Name: DR. GERRY G PROVANCE, DC
Title: CO-OWNER
Phone: (504) 456-9296

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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