Lisa D'nae Provence, DPT

NPI #1659680783 in Amherst, Texas

Provider Information

NPI Number: 1659680783
Entity Type: Individual
Name: Lisa D'nae Provence, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: DPT
Enumeration Date: Oct 7, 2010
Last Updated: Oct 7, 2010

Practice Location

Address: 1400 MAIN STREET
City: Amherst
State: Texas
ZIP Code: 79312
Phone: (806) 246-3483

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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