Individual
DR. JEAN-LUC LE PROVOST II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.D.
Contact information
Practice address
1225 N 36TH ST UNIT 1058, PHOENIX, AZ 85008-5308
(602) 377-3671
Mailing address
1225 N 36TH ST UNIT 1058, PHOENIX, AZ 85008-5308
(602) 377-3671
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
09-1139
AZ
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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