Individual
MRS. KARIS AMELIA PRUSAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
135 N GOULD ST, SHERIDAN, WY 82801-3927
(307) 674-1634
Mailing address
135 N GOULD ST, SHERIDAN, WY 82801-3927
(307) 674-1634
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
56
WY
Other
Enumeration date
08/14/2015
Last updated
08/14/2015
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