Individual
DEANNA M PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1101 SPRUCE ST, ELLIS, KS 67637-1757
(615) 896-6400
Mailing address
619 S IOWA ST, KANOPOLIS, KS 67454-9545
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1400978
KS
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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