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1386163707
CASEY PROVO
MEMPHIS, TN
NPI
1386163707
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: TN 3200)
Enumeration Date
2017-09-18
Last Update Date
2018-03-17
Business Address
CASEY PROVO MS, RDN, LDN
1689 NONCONNAH BLVD.
MEMPHIS, TN 38132
Phone number: 901-523-8990
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Mailing Address
CASEY PROVO MS, RDN, LDN
1156 WEST NATCHEZ POINT #72
MEMPHIS, TN 38103
Phone number:
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