Provo, Eric Landry
Provo, Eric Landry is an individual health care provider with primary practice located at 8857 1St St Ste 400 , Norfolk VA 23511-3713. He recently has only one registered license in Other Service Providers / Independent Duty Corpsman, which is considered as his primary health care specialty. Provo, Eric Landry can be contacted via phone (757) 445-7256.Contact Information
Primary practice address
8857 1St St Ste 400
Norfolk VA 23511-3713
Phone: (757) 445-7256
Fax: (757) 576-4161
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Independent Duty Corpsman | 1710I1002X |
Profile Details
| NPI number | 1407815392 |
|---|---|
| LBN Legal business name | Provo, Eric Landry |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2006 |
| Last updated | Oct 14th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407815392 | NPPES |
| Virginia | Other | 1710I1002X | INDEPENDENT DUTY CORPSMAN |
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