Individual
MARKIA PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 DELAWARE ST SE, GRAND RAPIDS, MI 49507-1229
(616) 419-6772
Mailing address
615 DELAWARE ST SE, GRAND RAPIDS, MI 49507-1229
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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