STACY PROVOST

WESTLAKE, OH
NPI1265640684
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: OH  01637)
Enumeration Date2007-05-18
Last Update Date2007-07-08
Business Address
-- STACY PROVOST PT
26520 CENTER RIDGE RD
WESTLAKE, OH 44145-4033
Phone number: 440-871-3030
Mailing Address
-- STACY PROVOST PT
3935 W 229TH ST
FAIRVIEW PARK, OH 44126-1041
Phone number:
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