ELLEN MICHELLE PROVOST

ANCHORAGE, AK
NPI1053344572
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207R00000X Internal Medicine
(Licence: AK  2717)
Enumeration Date2006-07-08
Last Update Date2008-10-17
Business Address
-- ELLEN MICHELLE PROVOST DO
4315 DIPLOMACY DR
ANCHORAGE, AK 99508-5926
Phone number: 907-729-1500
Mailing Address
-- ELLEN MICHELLE PROVOST DO
4315 DIPLOMACY DR
ANCHORAGE, AK 99508-5926
Phone number: 907-729-1500
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