Individual
JACOB PROVANCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 JACOB MURPHY LN STE 101, UNIONTOWN, PA 15401-2608
(724) 434-2720
Mailing address
202 JACOB MURPHY LN STE 101, UNIONTOWN, PA 15401-2608
(724) 434-2720
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE010421
PA
Other
Enumeration date
02/03/2015
Last updated
06/23/2022
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