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1699026930
MEREDITH GRAY PROVOST
SUMTER, SC
NPI
1699026930
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: SC 1827)
Enumeration Date
2012-09-26
Last Update Date
2012-09-26
Business Address
-- MEREDITH GRAY PROVOST PA-C
129 N WASHINGTON ST
SUMTER, SC 29150-4949
Phone number: 803-774-9000
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Mailing Address
-- MEREDITH GRAY PROVOST PA-C
129 N WASHINGTON ST
SUMTER, SC 29150-4949
Phone number: 843-270-3440
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