Individual
SOFIYA ALEXIS PRUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10923 OLIVE BLVD, CREVE COEUR, MO 63141-7740
(314) 764-2953
Mailing address
11708 RUSSET MEADOW DR, SAINT LOUIS, MO 63146-4231
(314) 440-8251
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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