MR. William A Provost JR., LMP
NPI #1649317827 in Colville, Washington
Provider Information
- NPI Number
- 1649317827
- Entity Type
- Individual
- Name
- MR. William A Provost JR., LMP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Massage Therapist
- Credential
- LMP
- Enumeration Date
- Jan 30, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 162 S MAIN ST
- City
- Colville
- State
- Washington
- ZIP Code
- 99114-2406
- Phone
- (509) 684-1420
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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