ALICIA P PROVENZANO

RALEIGH, NC
NPI1396098661
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NC  0010-06796)
Enumeration Date2012-10-23
Last Update Date2016-11-15
Business Address
-- ALICIA P PROVENZANO PA
3400 WAKE FOREST RD
RALEIGH, NC 27609-7317
Phone number: 919-862-2731
Mailing Address
-- ALICIA P PROVENZANO PA
PO BOX 63362
CHARLOTTE, NC 28263-3362
Phone number: 919-620-4700
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