NPI 1275495764

Adam Clay Pruitt

Practitioner Private Vehicle Saint Anthony, ID

Practice location

Address: 838 Hidden Estates Ln, Saint Anthony, ID 83445-5519
Phone: (901) 494-2969

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence 1275495764 (ID)

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Registry record

NPI: 1275495764
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Dec 2025
Record last updated: 23 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.