REBECCA BORDEAUX PROVOST

SUMMERVILLE, SC
NPI1538921721
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-01-24
Last Update Date2025-04-23
Business Address
Miss REBECCA BORDEAUX PROVOST
204 PARSONS RD
SUMMERVILLE, SC 29483-3348
Phone number: 854-201-3636
Mailing Address
Miss REBECCA BORDEAUX PROVOST
204 PARSONS RD
SUMMERVILLE, SC 29483-3348
Phone number: 854-201-3636