Individual
MR. TICCO DARRELL PRUITT SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3030 COVINGTON PIKE, SUITE 180, MEMPHIS, TN 38128-5048
(901) 870-2670
Mailing address
3030 COVINGTON PIKE, SUITE 180, MEMPHIS, TN 38128-5048
(901) 870-2670
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
TN
Other
Enumeration date
12/21/2011
Last updated
12/21/2011
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