Search › Ohio › 163W00000X
Alexander Provaznik
NPI 1578383725 · on the registry since 2024 · sole proprietor
Practice
- Address
- 902 Gallia St
Portsmouth, OH 45662 - Phone
- (740) 357-8615
- Organisation at this address
- Phoenix Group Home, Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 59
Registry record
- Primary taxonomy
- 163W00000X
163W00000X
- Licence states on file
- OH
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2024-10-14
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 Ohio