Individual
JAIME L PRUETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2536 W INDUSTRIAL PARK DR, STE 11, BLOOMINGTON, IN 47404-2635
(812) 332-7529
(812) 339-7529
Mailing address
2536 W INDUSTRIAL PARK DR, STE 11, BLOOMINGTON, IN 47404-2635
(812) 332-7529
(812) 339-7529
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001047A
IN
Other
Enumeration date
12/26/2007
Last updated
12/26/2007
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