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1275901878
PAUL DAVID PROVENZANO
JACKSONVILLE, FL
NPI
1275901878
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL PT30384)
Enumeration Date
2015-09-14
Last Update Date
2015-09-14
Business Address
Dr. PAUL DAVID PROVENZANO DPT
14546 OLD SAINT AUGUSTINE RD
JACKSONVILLE, FL 32258-5468
Phone number: 904-271-6575
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Mailing Address
Dr. PAUL DAVID PROVENZANO DPT
14546 OLD SAINT AUGUSTINE RD
JACKSONVILLE, FL 32258-5468
Phone number:
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