KRISTENE PROVO, PAC
Physician Assistant - Medical
Active
Individual
NPI: 1528002821
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Physician Assistant - Medical | 363AM0700X | Yes | 126 (MT) |
Frequently Asked Questions
NPI 1528002821 is the National Provider Identifier for KRISTENE PROVO, PAC, a Physician Assistant - Medical provider located in Missoula, MT. This NPI was enumerated on June 16, 2006.
KRISTENE PROVO, PAC practices at 2835 FORT MISSOULA ROAD, Missoula, MT 59804.
Quick Facts
- NPI
- 1528002821
- Type
- Individual
- Enumerated
- Jun 16, 2006
- Last Updated
- Feb 29, 2024
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