Mia Provenzano
Mia Provenzano is an Athletic Trainer in Mesa, Arizona. Practices as a sole proprietor. Registered with an NPI since 2015.
- In the registry since
- 2015
Practice location Address checks out
1320 S Val Vista Dr Apt 1066Mesa, AZ 85204-6491 Not confirmed with CMS for 11 years — call before visiting
Phone: (989) 964-1089
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Athletic Trainer (primary) | Taxonomy 2255A2300X |
|---|
Record details
| NPI number | 1093199499 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | July 15, 2015 |
| Last updated in NPPES | July 15, 2015 |
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