Individual
KIMBERLY M PRUCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
837 MOUNT ROSE ST, RENO, NV 89509-3224
(850) 797-0636
Mailing address
837 MOUNT ROSE ST, RENO, NV 89509-3224
(850) 797-0636
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT23248
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BN938Z
MEDICARE PTAN
FL
Enumeration date
03/26/2008
Last updated
11/30/2015
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