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Individual

LISA C PRUETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
1500 N LAKELINE BLVD, CEDAR PARK, TX 78613-6788
(512) 817-1842
Mailing address
512 GLACIAL STREAM LN, CEDAR PARK, TX 78613-7665
(737) 529-2496

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2136106
TX

Other

Enumeration date
10/19/2021
Last updated
10/19/2021
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