REBECCA BORDEAUX PROVOST

SUMMERVILLE, SC
NPI1538921721
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies363A00000X Physician Assistant
Enumeration Date2024-01-24
Last Update Date2024-01-24
Business Address
Miss REBECCA BORDEAUX PROVOST
121 WESTOE ST
SUMMERVILLE, SC 29483-8155
Phone number: 843-609-6805
Mailing Address
Miss REBECCA BORDEAUX PROVOST
121 WESTOE ST
SUMMERVILLE, SC 29483-8155
Phone number: 843-609-6805