Individual
ANDREW J PROVOST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
1 BRAINTREE ST ST, ALLSTON, MA 02134-1956
(617) 787-8700
(617) 787-8106
Mailing address
1 BRAINTREE ST ST, ALLSTON, MA 02134-1956
(617) 787-8700
(617) 787-8106
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/17/2011
Last updated
09/12/2012
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