Individual
WHITLEY PRUITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7908 CARLTON ARMS RD, INDIANAPOLIS, IN 46256-2807
(317) 476-4179
Mailing address
7908 CARLTON ARMS RD, INDIANAPOLIS, IN 46256-2807
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32002698A
IN
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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