-- DENISE PROVOOST PTA ⚕️ New Mexico 1962755009

NPI	1962755009
Entity Type	Individual
Gender	Female
Sole Proprietor ?	No
Primary Taxonomy	225200000X Physical Therapy Assistant (Licence: NM A0714)
Enumeration Date	2012-10-25
Last Update Date	2012-10-25

-- DENISE PROVOOST PTA

1515 EUBANK BLVD SE BLDG 832

ALBUQUERQUE, NM 87185

Phone number: 505-844-4237

-- DENISE PROVOOST PTA

512 CALIFORNIA STREET

ALBUQUERQUE, NM 87108

Phone number: 505-249-9698