Provider Demographics
NPI:1093140626
Name:PROVEY, ALLISON PAIGE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:PAIGE
Last Name:PROVEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7273 AVENTINE WAY APT 208
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-4169
Mailing Address - Country:US
Mailing Address - Phone:931-797-8386
Mailing Address - Fax:
Practice Address - Street 1:400 NORTH MARKET STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37405
Practice Address - Country:US
Practice Address - Phone:931-797-8386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2014-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14371183500000X
TN37957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist