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1730328501
ELIZABETH PROVOST
ALBUQUERQUE, NM
NPI
1730328501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NM 633)
Enumeration Date
2009-02-18
Last Update Date
2009-02-18
Business Address
-- ELIZABETH PROVOST PT
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106-2745
Phone number: 505-272-9870
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Mailing Address
-- ELIZABETH PROVOST PT
1650 UNIVERSITY BLVD NE SUITE 116
ALBUQUERQUE, NM 87102-1726
Phone number: 505-272-9870
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