Jeremy Travis Provost
Jeremy Travis Provost is a Counselor in Plymouth, Massachusetts. Practices as a sole proprietor. Registered with an NPI since 2012.
- In the registry since
- 2012
Practice location Address checks out
900 Ship Pond RdPlymouth, MA 02360
Phone: (617) 686-7901
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Counselor (primary) | Taxonomy 101Y00000X |
|---|
Record details
| NPI number | 1659635183 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | June 29, 2012 |
| Last updated in NPPES | June 29, 2012 |
| Mailing address | 900 Ship Pond Road, Plymouth, MA 02360 |
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