| NPI | 1245600618 |
|---|---|
| Doing Business As | PRUITT'S WELLNESS CLINIC, LLC |
| Entity Type | Organization |
| Authorized Contact | SHAWN DEGEORGE PRUITT Owner 615-562-6337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: TN 11293) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TN 11293) |
| 261QR1100X Clinic/Center, Research (Licence: TN 11293) | |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |