Provenzano, Mia

Provenzano, Mia is an sole proprietor health care provider with primary practice located at 1320 S Val Vista Dr Apt 1066 , Mesa AZ 85204-6491. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as her primary health care specialty. Provenzano, Mia can be contacted via phone (989) 964-1089.

Contact Information

Primary practice address
1320 S Val Vista Dr Apt 1066 Mesa AZ 85204-6491
Phone: (989) 964-1089
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1093199499
LBN Legal business name Provenzano, Mia
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 15th, 2015
Last updated Jul 15th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Popular Providers