Provo, Eric Landry

Provo, Eric Landry is an individual health care provider with primary practice located at 8857 1St St Ste 400 , Norfolk VA 23511-3713. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Provo, Eric Landry can be contacted via phone (757) 445-7256.

Contact Information

Primary practice address
8857 1St St Ste 400 Norfolk VA 23511-3713
Phone: (757) 445-7256
Fax: (757) 576-4161
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Corpsman 1710I1002X

Profile Details

NPI number 1407815392
LBN Legal business name Provo, Eric Landry
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2006
Last updated Oct 14th, 2009 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407815392 NPPES
Virginia Other 1710I1002X INDEPENDENT DUTY CORPSMAN

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