Individual
NATHAN WYATT PRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
600 CENTRAL AVE SE STE D, ALBUQUERQUE, NM 87102-4650
(505) 242-2294
Mailing address
2001 BUTTERFIELD RD STE 1600, DOWNERS GROVE, IL 60515-1211
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
28416
MD
225100000X
Physical Therapist
304229
CA
225100000X
Physical Therapist
40QA02245800
NJ
225100000X
Physical Therapist
CP031224T
DE
225100000X
Physical Therapist
CP035464T
GA
225100000X
Physical Therapist
Primary
CP051940T
CO
225100000X
Physical Therapist
J1-0014919
DE
225100000X
Physical Therapist
PT-2025-0197
NM
Other
Enumeration date
07/11/2021
Last updated
01/07/2026
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