WAYNE PROVINES

LITTLE ROCK AFB, AR
NPI1376506543
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152WX0102X Optometrist, Occupational Vision
(Licence: AR  9256)
Enumeration Date2006-04-10
Last Update Date2007-07-08
Business Address
Dr. WAYNE PROVINES O. D.
314 MDG/SGO, 1090 ARNOLD DR
LITTLE ROCK AFB, AR 72099-0001
Phone number: 501-987-8702
Mailing Address
Dr. WAYNE PROVINES O. D.
2812 GRAY FOX LN
JACKSONVILLE, AR 72076-2629
Phone number: 501-985-1185
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