Provision Healthcare, LLC
NPI #1669968152 in Columbia, South Carolina
Provider Information
- NPI Number
- 1669968152
- Entity Type
- Organization
- Organization Name
- Provision Healthcare, LLC
- Primary Specialty
- Nurse Practitioner - Family
- Enumeration Date
- Jul 8, 2018
- Last Updated
- Jul 8, 2018
Practice Location
- Address
- 1320 MAIN ST STE 300
- City
- Columbia
- State
- South Carolina
- ZIP Code
- 29201-3266
- Phone
- (803) 373-0063
Authorized Official
- Name
- MS. LASHONDA S TYLER, NP
- Title
- OWNER
- Phone
- (803) 302-8205
Specialties & Taxonomy Codes
| Specialty |
|---|
| Nurse Practitioner - Family — Family |
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