Individual
ALEXANDER CRAIG PROVAZNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
902 GALLIA ST, PORTSMOUTH, OH 45662-4139
(740) 357-8615
Mailing address
902 GALLIA ST, PORTSMOUTH, OH 45662-4139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.508736
OH
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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