ETHAN PRUSSE

TOOELE, UT
NPI1023905924
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
(Licence: UT  0)
Enumeration Date2025-06-23
Last Update Date2025-06-23
Business Address
ETHAN PRUSSE
100 S 1000 W
TOOELE, UT 84074-4010
Phone number: 888-949-4864
Mailing Address
ETHAN PRUSSE
3725 W 4100 S STE 201
WEST VALLEY CITY, UT 84120-6490
Phone number: