DR. Jonathan Michael Provost, PT, DPT, SCS

NPI #1619377751 in Hadley, Massachusetts

Provider Information

NPI Number: 1619377751
Entity Type: Individual
Name: DR. Jonathan Michael Provost, PT, DPT, SCS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT, SCS
Enumeration Date: Aug 26, 2014
Last Updated: Oct 31, 2022

Practice Location

Address: 241 RUSSELL ST
City: Hadley
State: Massachusetts
ZIP Code: 01035-9558
Phone: (413) 586-5552

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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