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1194395210
CHARLES LEWIS HUMPHREY PRUETT
ATLANTA, GA
NPI
1194395210
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-06-30
Last Update Date
2021-06-30
Business Address
CHARLES LEWIS HUMPHREY PRUETT
100 WOODRUFF CIR NE STE P375
ATLANTA, GA 30322-1020
Phone number: 404-727-5655
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Mailing Address
CHARLES LEWIS HUMPHREY PRUETT
100 WOODRUFF CIR NE STE P375
ATLANTA, GA 30322-1020
Phone number: 404-727-5655
Copy
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