JEREMY EDWARD PRUITT

FPO, AA
NPI1992939458
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2009-05-12
Last Update Date2009-05-12
Business Address
-- JEREMY EDWARD PRUITT IDC
USS WARRIOR MCM 10 CREW CONSTANT - EH01
FPO, AA 34093-1930
Phone number: 361-385-0592
Mailing Address
-- JEREMY EDWARD PRUITT IDC
140 SYLVESTER RD COMCMRON TWO BLDG. 139
SAN DIEGO, CA 92106-3521
Phone number: 619-524-9654
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