Proctors Provision Llc.

NPI #1821698374 in Columbia, Missouri

Provider Information

NPI Number: 1821698374
Entity Type: Organization
Organization Name: Proctors Provision Llc.
Primary Specialty: Home Health
Enumeration Date: Oct 26, 2020
Last Updated: Oct 26, 2020

Practice Location

Address: 1809 VANDIVER DR STE 105
City: Columbia
State: Missouri
ZIP Code: 65202-3948
Phone: (573) 814-8528

Authorized Official

Name: MARIAH TA'SHEA PROCTOR
Title: OWNER/CEO
Phone: (573) 814-8528

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Home Health	251E00000X	Primary

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