Gerry G Provance in Metairie - Sports Physician
Gerry G Provance - NPI 1063555662
Gerry G Provance is a Sports Physician in Metairie, Louisiana. Gerry G Provance practices all healthcare services and medical treatments related to Sports Physician. The NPI Number for Gerry G Provance is 1063555662. The last update date is 2007-07-08.
Gerry G Provance's current location address is 2007 Clearview Pkwy, Metairie, Louisiana. You can contact this provider via phone number 5044569296 and fax number 5044569799. The mailing address for Gerry G Provance is 2007 Clearview Pkwy, Metairie, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gerry G Provance |
|---|---|
| Address | 2007 Clearview Pkwy, Metairie, Louisiana |
| Phone Number | 5044569296 |
| Fax Number | 5044569799 |
| Sole Proprietor | N |
| Credentials | D.C. |
NPI Number Detail
| NPI Number | 1063555662 |
|---|---|
| Provider Enumeration Date | 2007-02-14 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2007 Clearview Pkwy |
|---|---|
| City | Metairie |
| State | Louisiana (LA) |
| Post Code | 700012404 |
| Phone Number | 5044569296 |
| Fax Number | 5044569799 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Physician |
|---|---|
| Taxonomy | 111Ns0005X |
| Licence No | 414 |
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Definition: A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| C8327 | LA | BLUE CROSS ID | |
| 1951340 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Gerry G Provance by the Centers for Medicare & Medicaid Services?
The Gerry G Provance has been issued the NPI (National Provider Identifier) 1063555662, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Gerry G Provance's facilities are situated?
The facilities of Gerry G Provance are physically located at the following address: 2007 Clearview Pkwy, Metairie, LA, 700012404.
What is Gerry G Provance's specialized field of practice, and what is the corresponding taxonomy classification code?
The Gerry G Provance's area of specialization is Sports Physician, and the corresponding taxonomy code that categorizes this field of practice is 111Ns0005X.
On what date did the Gerry G Provance receive the assignment of its 1063555662 from the Centers for Medicare & Medicaid Services?
The Gerry G Provance was issued its 1063555662 by the Centers for Medicare & Medicaid Services on 2007-02-14.
When was the information regarding Gerry G Provance most recently updated?
The details pertaining to the Gerry G Provance, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.
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