KRYSTIN JADE PROVO

OTTAWA, KS
NPI1598100448
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy111N00000X Chiropractor
(Licence: KS  01-05533)
Enumeration Date2013-05-06
Last Update Date2022-07-21
Business Address
Dr. KRYSTIN JADE PROVO D.C
112 E 17TH ST
OTTAWA, KS 66067-3800
Phone number: 785-242-9393
Mailing Address
Dr. KRYSTIN JADE PROVO D.C
112 E 17TH ST
OTTAWA, KS 66067-3800
Phone number: 785-242-9393
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