MRS. Kimberly K Provoast, PA

NPI #1770899551 in West Branch, Michigan

Provider Information

NPI Number
1770899551
Entity Type
Individual
Name
MRS. Kimberly K Provoast, PA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant
Credential
PA
Enumeration Date
Aug 31, 2010
Last Updated
Oct 18, 2012

Practice Location

Address
337 E HOUGHTON AVE
ZIP Code
48661-1127
Phone
(989) 345-5240

Specialties & Taxonomy Codes

Specialty
Physician Assistant

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