Individual
ANNABETH PRUETT BARRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C, MBA
Contact information
Practice address
424 E STROOP RD UNIT B, KETTERING, OH 45429-2845
(937) 562-2300
(937) 562-2302
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4262
TN
363A00000X
Physician Assistant
Primary
50.007429RX
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/16/2019
Last updated
02/29/2024
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