Individual
PHILIP PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4770 TOPAZ ST, 84, LAS VEGAS, NV 89121-5508
(702) 672-4789
Mailing address
4770 TOPAZ ST UNIT 84, LAS VEGAS, NV 89121-5509
(702) 672-4789
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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