Individual
JENNA PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18765 RIVERSIDE DRIVE, VANSANT, VA 24656
(276) 935-7455
(276) 935-7713
Mailing address
18765 RIVERSIDE DRIVE, VANSANT, VA 24656
(276) 935-7455
(276) 935-7713
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202213091
VA
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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