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1689105454
YVETTE PROVOSTY
MEDFORD, OR
NPI
1689105454
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR 04969)
Enumeration Date
2017-03-23
Last Update Date
2017-03-23
Business Address
-- YVETTE PROVOSTY
400 CRATER LAKE AVE
MEDFORD, OR 97504-6808
Phone number: 541-613-6505
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Mailing Address
-- YVETTE PROVOSTY
610 HIGH ST
OREGON CITY, OR 97045-2241
Phone number: 503-657-8903
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