Individual
WILHELMINA LISA PRUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1221 DURSTON RD, BOZEMAN, MT 59715-2725
(406) 582-3300
Mailing address
404 S 6TH AVE, BOZEMAN, MT 59715-4562
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2354PTA
MT
Other
Enumeration date
04/13/2011
Last updated
04/13/2011
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