Individual
DR. TERRA L PROVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
1203 28TH ST S, FARGO, ND 58103-8711
(218) 303-9003
(888) 651-4713
Mailing address
206 SHEYENNE DR, HORACE, ND 58047-4418
(218) 303-9003
(888) 651-4713
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
13-1372
AZ
175F00000X
Naturopath
Primary
2017-02
ND
175F00000X
Naturopath
ND774
CA
Other
Enumeration date
08/06/2013
Last updated
09/10/2019
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