Sonnie Provitt

NPI #1245915578 in Tallmadge, Ohio

Provider Information

NPI Number: 1245915578
Entity Type: Individual
Name: Sonnie Provitt
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Health Worker
Enumeration Date: Jun 15, 2023
Last Updated: Jun 15, 2023

Practice Location

Address: 30 NORTHWEST AVE STE 120
City: Tallmadge
State: Ohio
ZIP Code: 44278-1808
Phone: (330) 633-4187

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Health Worker	172V00000X	Primary

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