KACEY HELENA PROVENZANO

RICHLAND, WA
NPI1740523158
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208800000X Urology
(Licence: WA  MD60964556)
Additional Taxonomies208800000X Urology
(Licence: MA  264720)
Enumeration Date2013-04-03
Last Update Date2021-06-23
Business Address
KACEY HELENA PROVENZANO M.D.
780 SWIFT BLVD STE 201
RICHLAND, WA 99352
Phone number: 509-942-3288
Mailing Address
KACEY HELENA PROVENZANO M.D.
550 GAGE BLVD STE 101
RICHLAND, WA 99352-9532
Phone number: 509-942-3288