Individual
HOLLY JO PRUETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2900 CHARLEVOIX DR SE, SUITE 200, GRAND RAPIDS, MI 49546-7085
(180) 063-4107
(616) 975-5030
Mailing address
2900 CHARLEVOIX DR SE, SUITE 200, GRAND RAPIDS, MI 49546-7085
(180) 063-4107
(616) 975-5030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/17/2012
Last updated
07/17/2012
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