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Organization
THE LITTLE CLINIC OF INDIANA LLC
Active
Organization
THE LITTLE CLINIC OF INDIANA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY PRUITT ESQUIRE (SECRETARY)
(502) 301-7408
Entity
Organization
Contact information
Practice address
2956 E 10TH ST, JEFFERSONVILLE, IN 47130-5914
(812) 284-2488
(812) 284-3291
Mailing address
9721 ORMSBY STATION RD, STE 106, LOUISVILLE, KY 40223-4095
(502) 423-1103
(502) 423-1699
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/11/2006
Last updated
08/22/2020
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