KENNA PROVOST FAREK

LUBBOCK, TX
NPI1609624097
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: TX  BP10090108)
Enumeration Date2024-05-09
Last Update Date2024-05-09
Business Address
KENNA PROVOST FAREK MD
3601 4TH ST # MS 9901
LUBBOCK, TX 79430-0002
Phone number: 806-743-2757
Mailing Address
KENNA PROVOST FAREK MD
3601 4TH ST # MS 9901
LUBBOCK, TX 79430-0002
Phone number:
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