Individual
DR. CYNTHIA PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2985 GAUSE BLVD E, SLIDELL, LA 70461-4154
(985) 639-1560
(985) 639-1561
Mailing address
2985 GAUSE BLVD E, SLIDELL, LA 70461-4154
(985) 639-1560
(985) 639-1561
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16836
LA
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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