Individual
KASEY JO LANTRIP-PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
205 N BONNIE BRAE ST, DENTON, TX 76201-3766
(940) 703-7227
Mailing address
608 CADDELL ST, AUBREY, TX 76227-9231
(940) 390-0084
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2083287
TX
Other
Enumeration date
08/19/2018
Last updated
08/19/2018
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