Individual
KRISTA MICHELLE PRUSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3026 E 1610 S, SPANISH FORK, UT 84660-8921
(801) 310-9987
Mailing address
3026 E 1610 S, SPANISH FORK, UT 84660-8921
(801) 310-9987
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
7479128-4810
UT
Other
Enumeration date
05/12/2014
Last updated
05/12/2014
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