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Individual

DR. VINCENT R PRUSICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4045 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-0900
(231) 935-0308
Mailing address
4045 W ROYAL DR, TRAVERSE CITY, MI 49684-8965
(231) 935-0900
(231) 935-0308

Taxonomy

Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
4301044833
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103105033
MI
Enumeration date
07/26/2006
Last updated
02/18/2022
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