Provost Shoes
Provost Shoes is a Durable Medical Equipment & Medical Supplies in Hazleton, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2007.
- Licensed in
- PA
- In the registry since
- 2007
Practice location Address checks out
25 Laurel MallHazleton, PA 18202-1201
Phone: (570) 455-7704
Fax: (570) 455-7704
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Durable Medical Equipment & Medical Supplies (primary) | Taxonomy 332B00000X · Licence 4244780002 (PA) |
|---|
Record details
| NPI number | 1447431945 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | John Provost — Owner · (570) 455-7704 |
| NPI enumerated | November 26, 2007 |
| Last updated in NPPES | December 5, 2007 |
| Mailing address | 25 Laurel Mall, Hazleton, PA 18202-1201 |
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-
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Mr. John Marshall Provost, CPED
25 Laurel Mall Provost Shoes, Hazleton, PA 18202-1201 · (570) 455-7704
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