Individual
JOSEPH PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
85 PRESCOTT ST STE 403, WORCESTER, MA 01605-2671
(087) 537-2595
(508) 753-9577
Mailing address
85 PRESCOTT ST STE 403, WORCESTER, MA 01605-2671
(087) 537-2595
(508) 753-9577
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA6530
MA
Other
Enumeration date
02/26/2019
Last updated
04/20/2021
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