Individual
JONI E PRUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
LYSTER ARMY HEALTH CLINIC, BLDG 301 ANDREWS AVE, FORT RUCKER, AL 36362-5333
(334) 255-7169
Mailing address
LYSTER ARMY HEALTH CLINIC, BLDG 301 ANDREWS AVE, FORT RUCKER, AL 36362-5333
(334) 255-7169
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
111126
AK
225200000X
Physical Therapy Assistant
3367
TN
225200000X
Physical Therapy Assistant
Primary
PTA6413
AL
Other
Enumeration date
07/11/2019
Last updated
07/11/2019
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