Healthcare Provider Details

I. General information

NPI: 1992618599
Provider Name (Legal Business Name): PRUITTHEALTH THERAPY SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1626 JEURGENS CT
NORCROSS GA
30093-2219
US

IV. Provider business mailing address

1626 JEURGENS CT
NORCROSS GA
30093-2219
US

V. Phone/Fax

Practice location:
  • Phone: 678-296-0751
  • Fax:
Mailing address:
  • Phone: 678-296-0751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NEIL PRUITT JR.
Title or Position: CHAIRMAN AND CEO
Credential:
Phone: 770-279-6200