Individual
CHRISTINE MARIE PRUISMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
301 N ANKENY BLVD, ANKENY, IA 50023-1730
(850) 866-5528
Mailing address
102 DESTINY DR, BOONE, IA 50036-1211
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
098179
IA
Other
Enumeration date
10/21/2020
Last updated
11/23/2020
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