Individual ProviderAllie PruettPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address3901 University Blvd S, Jacksonville, FL 32216-4312(904) 345-6920(904) 345-7310PECOS EnrollmentBased on the most recent information from CMS, provider Allie Pruett does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1093317455Provider TypeIndividualFull NamePruett, AllieCredentialPT, DPTGenderFemaleSole ProprietorNoEnumeration Date11/11/2020Last Updated7/20/2023Contact InformationPractice LocationPractice Address3901 University Blvd S, Jacksonville, FL 32216-4312Phone(904) 345-6920FaxUnlisted FaxMailing LocationMailing Address3901 University Blvd S, Jacksonville, FL 32216-4312Phone(904) 345-7310FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT36210FloridaCode2251P0200XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense2305213885Virginia