Individual
BRADLY PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1300 W BROAD ST, RICHMOND, VA 23284-9089
(804) 828-2321
Mailing address
7610 BETH RD APT C, HENRICO, VA 23228-3539
(434) 210-0935
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001219
VA
Other
Enumeration date
03/26/2015
Last updated
03/26/2015
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