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1003187501
HOLLY LYNN PROVANCE
TAMPA, FL
NPI
1003187501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: FL ps0028640)
Enumeration Date
2012-01-16
Last Update Date
2012-01-16
Business Address
-- HOLLY LYNN PROVANCE rph
6503 W WATERS AVE
TAMPA, FL 33634-2207
Phone number: 813-887-3166
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Mailing Address
-- HOLLY LYNN PROVANCE rph
6503 W WATERS AVE
TAMPA, FL 33634-2207
Phone number: 813-887-3166
Copy
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