Individual
DR. ANTONIO VA'SHAWN PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT,DPT,MPA
Contact information
Practice address
700 MARIETTA ST NW STE B, ATLANTA, GA 30318-5726
(678) 705-3091
Mailing address
PO BOX 93684, ATLANTA, GA 30377-0684
(678) 705-3091
(404) 794-8787
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011344
GA
Other
Enumeration date
08/10/2009
Last updated
03/22/2018
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