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Individual

DR. DAVID PROVAZNIK JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
627 S EDWIN C MOSES BLVD, EAST MEDICAL PLAZA 1ST FLOOR, DAYTON, OH 45417-3461
(937) 223-8840
Mailing address
627 S EDWIN C MOSES BLVD, EAST MEDICAL PLAZA 1ST FLOOR, DAYTON, OH 45417-3461
(937) 223-8840

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
XXXXXXXXXX
OH

Other

Enumeration date
04/06/2015
Last updated
04/06/2015
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