MEREDITH GRAY PROVOST

SUMTER, SC
NPI1699026930
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant Medical
(Licence: SC  1827)
Enumeration Date2012-09-26
Last Update Date2012-09-26
Business Address
MEREDITH GRAY PROVOST PA-C
129 N WASHINGTON ST
SUMTER, SC 29150-4949
Phone number: 803-774-9000
Mailing Address
MEREDITH GRAY PROVOST PA-C
129 N WASHINGTON ST
SUMTER, SC 29150-4949
Phone number: 843-270-3440
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