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1205202181
KARIS AMELIA PRUSAK
SHERIDAN, WY
NPI
1205202181
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: WY 56)
Enumeration Date
2015-08-14
Last Update Date
2015-08-14
Business Address
Mrs. KARIS AMELIA PRUSAK ATC, LAT
135 N GOULD ST
SHERIDAN, WY 82801-3927
Phone number: 307-674-1634
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Mailing Address
Mrs. KARIS AMELIA PRUSAK ATC, LAT
135 N GOULD ST
SHERIDAN, WY 82801-3927
Phone number: 307-674-1634
Copy
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