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Individual

MRS. LORRAINE MARIE PROVOST

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1063 S STATE RD STE 1, DAVISON, MI 48423-1900
(810) 653-3277
(810) 653-3244
Mailing address
1063 S STATE RD STE 1, DAVISON, MI 48423-1900
(810) 653-3277
(810) 653-3244

Taxonomy

Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3501002446
MI

Other

Enumeration date
03/26/2011
Last updated
03/26/2011
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