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1134787286
COURTNEY LYNN PROVOST
SALT LAKE CITY, UT
NPI
1134787286
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-06-04
Last Update Date
2019-06-04
Business Address
COURTNEY LYNN PROVOST
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
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Mailing Address
COURTNEY LYNN PROVOST
4460 S HIGHLAND DR
SALT LAKE CITY, UT 84124-3543
Phone number: 888-949-4864
Copy
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