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1285620641
GEORGE L PROVOST
ALLENTOWN, PA
NPI
1285620641
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: PA MD020842E)
Enumeration Date
2005-09-21
Last Update Date
2010-09-10
Business Address
-- GEORGE L PROVOST MD
1210 HANOVER AVE
ALLENTOWN, PA 18109-2017
Phone number: 610-437-6490
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Mailing Address
-- GEORGE L PROVOST MD
421 W CHEW ST
ALLENTOWN, PA 18102-3406
Phone number: 610-776-5100
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