Provenzano, Michael Louis
Provenzano, Michael Louis is an individual health care provider with primary practice located at 16 Haverhill St , Andover MA 01810-3002. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Chiropractic Providers / Chiropractor. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Provenzano, Michael Louis can be contacted via phone (978) 470-1499.Contact Information
Primary practice address
16 Haverhill St
Andover MA 01810-3002
Phone: (978) 470-1499
Fax: (978) 470-1408
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 18057 | Massachusetts |
| Chiropractic Providers / Chiropractor | 111N00000X | 2154 | Massachusetts |
Profile Details
| NPI number | 1225157423 |
|---|---|
| LBN Legal business name | Provenzano, Michael Louis |
| Credentials | D.C.,D.P.T |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 28th, 2007 |
| Last updated | Dec 17th, 2025 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225157423 | NPPES |
| Massachusetts | Other | 4400518 | UNITED HEALTH CARE |
| Massachusetts | Other | 657211 | UNITED HEALTH CARE |
| Massachusetts | Other | Y36610 | UNITED HEALTH CARE |
| Massachusetts | Other | 0017863 | UNITED HEALTH CARE |
| Massachusetts | Other | B2008591-01 | UNITED HEALTH CARE |
| Massachusetts | Other | 99428401 | UNITED HEALTH CARE |
| Massachusetts | Other | 3345755 | UNITED HEALTH CARE |
| Massachusetts | Other | AA42230 | UNITED HEALTH CARE |
| Massachusetts | Other | Y39894 | UNITED HEALTH CARE |
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