Individual
JAIMIE PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
100 ANNA GOODE WAY, SUFFOLK, VA 23434-9236
(757) 923-5500
Mailing address
3100 SOMME AVE APT B, NORFOLK, VA 23509-1844
(240) 676-5775
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306605691
VA
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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