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Individual
DR. MICHAEL LOUIS PROVENZANO
Active
Individual
DR. MICHAEL LOUIS PROVENZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.,D.P.T
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
2154
MA
225100000X
Physical Therapist
Primary
18057
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0017863
NEIGHBORHOOD HEALTH
MA
01
—
3345755
AETNA
MA
01
—
4400518
UNITED HEALTH CARE
MA
01
—
657211
HARVARD NON PRACTICE
MA
01
—
99428401
NETWORK HEALTH
MA
01
—
AA42230
HARVARD PILGRIM
MA
01
—
B2008591-01
CIGNA
MA
01
—
Y36610
BLUE CROSS
MA
01
—
Y39894
BLUE CROSS
MA
Enumeration date
03/28/2007
Last updated
12/17/2025
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