Individual
CHRISTINE F PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 STONEY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
Mailing address
403 STONEY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
054809
SC
Other
Enumeration date
09/05/2007
Last updated
09/05/2007
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