COURTNEY PROVENCAL

LOUISVILLE, KY
NPI1184963464
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: RI  00838)
Additional Taxonomies225200000X Physical Therapy Assistant
(Licence: MA  8708)
Enumeration Date2013-02-06
Last Update Date2013-02-06
Business Address
-- COURTNEY PROVENCAL PTA
303 N HURSTBOURNE PKWY SUITE 200
LOUISVILLE, KY 40222-5185
Phone number: 502-412-5847
Mailing Address
-- COURTNEY PROVENCAL PTA
673 E 2ND ST UNIT #1
BOSTON, MA 02127-1547
Phone number: