LAURA PROVENZANO

ALEXANDRIA, VA
NPI1396080800
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: VA  0110004424)
Enumeration Date2012-12-10
Last Update Date2017-12-12
Business Address
LAURA PROVENZANO PA-C
3117 DUKE ST
ALEXANDRIA, VA 22314-4518
Phone number: 703-751-8800
Mailing Address
LAURA PROVENZANO PA-C
1563 ONYX DR UNIT 205
MC LEAN, VA 22102-3945
Phone number: 703-585-5951
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