Individual
DENISE PATRICIA PROVENCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
25500 MEADOWBROOK RD STE 150, NOVI, MI 48375-1880
(248) 784-3667
(248) 869-3982
Mailing address
25500 MEADOWBROOK RD STE 150, NOVI, MI 48375-1880
(248) 784-3667
(248) 869-3982
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003979
MI
Other
Enumeration date
08/05/2006
Last updated
03/05/2025
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