Search › Hawaii › 171100000X
Antonio Provencio, LAC
NPI 1821598699 · on the registry since 2018 · sole proprietor
Practice
- Address
- 98-199 Kamehameha Hwy Ste F3
Aiea, HI 96701 - Phone
- (808) 364-1555
- Organisation at this address
- Gale Marana Dds
Iuc Holdings Inc
Gammie Homecare, Inc.
The Queens Medical Center
East 2 West Integrative Medicine LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 8
Registry record
- Primary taxonomy
- 171100000X
171100000X
- Also registered as
- 171100000X
225700000X - Licence states on file
- CA, HI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-07-29
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 Hawaii