Individual
LEVI DAVID PRUITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
661 ADDISON DR, WYNNE, AR 72396-1602
(870) 238-1135
(870) 238-1139
Mailing address
2707 BROWNS LN, JONESBORO, AR 72401-7213
(870) 972-4939
(870) 972-4911
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
AR
Other
Enumeration date
12/10/2018
Last updated
12/10/2018
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