MICHELE T PROVOST

NORWICH, NY
NPI1043388754
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: NY  011639)
Enumeration Date2006-12-01
Last Update Date2010-11-19
Business Address
-- MICHELE T PROVOST PA
45-47 HALE STREET
NORWICH, NY 13815-2038
Phone number: 607-336-1749
Mailing Address
-- MICHELE T PROVOST PA
45-47 HALE STREET
NORWICH, NY 13815-2038
Phone number: 607-336-1749
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