MR. John Marshall Provost, C.PED
NPI #1992821920 in Hazleton, Pennsylvania
Provider Information
- NPI Number
- 1992821920
- Entity Type
- Individual
- Name
- MR. John Marshall Provost, C.PED
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Durable Medical Equipment & Medical Supplies
- Credential
- C.PED
- Enumeration Date
- Mar 21, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 25 LAUREL MALL
- Address 2
- PROVOST SHOES
- City
- Hazleton
- State
- Pennsylvania
- ZIP Code
- 18202-1201
- Phone
- (570) 455-7704
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies |
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