TAMMY LYNN PROVATAS

GRAND RAPIDS, MI
NPI1275795239
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: MI  4301092916)
Enumeration Date2008-06-30
Last Update Date2008-06-30
Business Address
Dr. TAMMY LYNN PROVATAS M.D.
100 MICHIGAN ST NE # MC-49
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-8879
Mailing Address
Dr. TAMMY LYNN PROVATAS M.D.
1699 SYCAMORE DR
MUSKEGON, MI 49445-3400
Phone number: 231-740-3750