Individual
JA'VIUS PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1921 15TH ST SW, BIRMINGHAM, AL 35211-5028
(205) 565-9139
Mailing address
1921 15TH ST SW, BIRMINGHAM, AL 35211-5028
(205) 565-9139
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
PX3Y2J5W5
AL
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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