Individual
MISS MADISON KORIANNA PRUITT-PURIFOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1288 LYTLE LN, KETTERING, OH 45409-2114
(251) 599-7450
Mailing address
1288 LYTLE LN, KETTERING, OH 45409-2114
(251) 599-7450
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
602462090723
OH
Other
Enumeration date
02/22/2024
Last updated
02/22/2024
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