Individual
JOSHUA PRUDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
602 EASY ST APT D, BROOKINGS, OR 97415-9198
(541) 852-8286
Mailing address
602 EASY ST APT D, BROOKINGS, OR 97415-9198
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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