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Individual

DR. JAY A PROVENZANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
25 SCHOOL ST, SUITE B-2, QUINCY, MA 02169-6607
(617) 689-0440
(617) 689-0420
Mailing address
25 SCHOOL ST, SUITE B-2, QUINCY, MA 02169-6607
(617) 689-0440
(617) 689-0420

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2886
MA

Other

Enumeration date
12/04/2006
Last updated
06/09/2010
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