MARK PRUITT

BONNERS FERRY, ID
NPI1124432943
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207P00000X Emergency Medicine
(Licence: ID  O-1105)
Enumeration Date2014-06-19
Last Update Date2019-06-25
Business Address
MARK PRUITT D.O.
6640 KANIKSU ST
BONNERS FERRY, ID 83805
Phone number: 208-267-3141
Mailing Address
MARK PRUITT D.O.
6640 KANIKSU ST
BONNERS FERRY, ID 83805-7532
Phone number: 208-267-3141
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