Search › Georgia › 111N00000X
Bethany Provencial, DC
NPI 1497638084 · on the registry since 2025
Practice
- Address
- 1709 Mount Vernon Rd Ste C
Dunwoody, GA 30338 - Phone
- (706) 968-7179
- Organisation at this address
- Speechfamily
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 3
Registry record
- Primary taxonomy
- 111N00000X
111N00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2025-07-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia