Organization
GERIACTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMANDA PRUITT PT, DPT (OWNER/PHYSICAL THERAPIST)
(606) 424-7483
Entity
Organization
Contact information
Practice address
335 STREAMLAND DR, DANVILLE, KY 40422-1081
(606) 424-7483
Mailing address
PO BOX 1872, DANVILLE, KY 40423-1872
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
02/22/2022
Last updated
03/15/2022
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