Most Relevant Information
Provider Data
| NPI Number: | 1003440223 |
| Provider Name: | WILLIAM PROVOSTY |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/26/2020 |
| Last Updated: | 02/26/2020 |
Provider Practice Location
1430 TULANE AVE
NEW ORLEANS
LA
701122632
Practice Location Phone/Fax
| Phone: | 5049885462 |
| Fax: |
Provider Mailing Location
1430 TULANE AVE
NEW ORLEANS
LA
701122632
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |