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1558108241
LUKE PROVCHY
EL SEGUNDO, CA
NPI
1558108241
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2024-07-10
Last Update Date
2024-07-10
Business Address
LUKE PROVCHY
100 N PACIFIC COAST HWY
EL SEGUNDO, CA 90245-4359
Phone number: 310-304-0532
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Mailing Address
LUKE PROVCHY
100 N PACIFIC COAST HWY
EL SEGUNDO, CA 90245-4359
Phone number: 310-304-0532
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