JACKIE PROVOST

LOS ANGELES, CA
NPI1346591963
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy174H00000X Health Educator
Enumeration Date2012-09-21
Last Update Date2012-09-21
Business Address
-- JACKIE PROVOST MPH
5849 CROCKER ST UNIT K
LOS ANGELES, CA 90003-1311
Phone number: 323-406-5784
Mailing Address
-- JACKIE PROVOST MPH
5849 CROCKER ST UNIT K
LOS ANGELES, CA 90003-1311
Phone number:
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