Emily Provence

NPI #1063861938 in Atoka, Tennessee

Provider Information

NPI Number: 1063861938
Entity Type: Individual
Name: Emily Provence
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Jun 10, 2016
Last Updated: Jun 10, 2016

Practice Location

Address: 139 WESLEY REED DR
Address 2: SUITE F
City: Atoka
State: Tennessee
ZIP Code: 38004-4905
Phone: (901) 837-8801

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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