DERRICK WAYNE PRUITT

TULSA, OK
NPI1912741919
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2024-06-24
Last Update Date2024-06-24
Business Address
DERRICK WAYNE PRUITT Medical Student
1111 W 17TH ST
TULSA, OK 74107-1886
Phone number: 918-582-1972
Mailing Address
DERRICK WAYNE PRUITT Medical Student
5749 E 30TH ST
TULSA, OK 74114-6412
Phone number: 405-609-9114
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