Individual
MS. STEPHANIE MARIE PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
421 WOODLAND BLVD, UNIT 8317, DELAND, FL 32723-0001
(386) 822-7158
Mailing address
620 MUSCOVY CIR, APT. F, DELAND, FL 32720-1496
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 1818
FL
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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