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1073907135
BRADLY PRUETT
RICHMOND, VA
NPI
1073907135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126001219)
Enumeration Date
2015-03-26
Last Update Date
2015-03-26
Business Address
-- BRADLY PRUETT MS, ATC
1300 W BROAD ST
RICHMOND, VA 23284-9089
Phone number: 804-828-2321
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Mailing Address
-- BRADLY PRUETT MS, ATC
7610 BETH RD APT C
HENRICO, VA 23228-3539
Phone number: 434-210-0935
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