Individual
RANDAL PRUIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2101 N MAIN ST, CLOVIS, NM 88101-3511
(575) 693-6205
Mailing address
2101 N MAIN ST, CLOVIS, NM 88101-3511
(575) 693-6205
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
—
—
171WV0202X
Vehicle Modifications Contractor
—
—
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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