ELIZABETH MARIE PROVOST

GASTONIA, NC
NPI1861837114
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: NC  191393)
Enumeration Date2013-04-30
Last Update Date2024-01-03
Business Address
ELIZABETH MARIE PROVOST MD
885 SUMMIT CROSSING PL
GASTONIA, NC 28054-2193
Phone number: 704-316-4979
Mailing Address
ELIZABETH MARIE PROVOST MD
PO BOX 60447
CHARLOTTE, NC 28260-0447
Phone number: 704-316-4979
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