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Dr. Antonio Va'Shawn Pruitt, PT,DPT,MPA

Physical Therapist in Atlanta, GA. Individual provider (NPI-1).

NPI number1457583403
StatusActive
Last updated in NPPESMar 22, 2018

Details

NPI
1457583403
Entity type
Individual (NPI-1)
Name
Dr. Antonio Va'Shawn Pruitt
Credential
PT,DPT,MPA
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 10, 2009
Last updated
Mar 22, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical TherapistPT011344GAYes

Practice location

700 Marietta St Nw Ste B
Atlanta, GA 30318-5726

Phone 678-705-3091

Mailing address

Po Box 93684
Atlanta, GA 30377-0684

Phone 678-705-3091 · Fax 404-794-8787

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