Shenise Lastine Pruitt

NPI #1477879351 in Olivette, Missouri

Provider Information

NPI Number
1477879351
Entity Type
Individual
Name
Shenise Lastine Pruitt
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Contractor
Enumeration Date
Apr 16, 2010
Last Updated
Apr 16, 2010

Practice Location

Address
9648 OLIVE BLVD
ZIP Code
63132-3002
Phone
(314) 641-9930

Specialties & Taxonomy Codes

Specialty
Contractor

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