Stacey A Pruitt Od,inc
Optometrist in Greenfield, IN. Organization (NPI-2).
NPI number1508322009
StatusActive
Last updated in NPPESFeb 20, 2019
Details
- NPI
- 1508322009
- Entity type
- Organization (NPI-2)
- Legal business name
- Stacey A Pruitt Od,inc
- Organization subpart
- No
- Enumeration date
- Feb 20, 2019
- Last updated
- Feb 20, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
Practice location
1250 N State StGreenfield, IN 46140-1055
Phone 812-614-1411
Mailing address
10639 Windjammer CirIndianapolis, IN 46236-8934
Phone 812-614-1411
Authorized official
Stacey A Pruitt
Optometrist
8126141411
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