Carol Anne Pettibone
NPI #1114704319 in Walla Walla, Washington
Provider Information
- NPI Number
- 1114704319
- Entity Type
- Individual
- Name
- Carol Anne Pettibone
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Sep 11, 2023
- Last Updated
- Sep 11, 2023
Practice Location
- Address
- 1840 GRAY LYNN DR
- City
- Walla Walla
- State
- Washington
- ZIP Code
- 99362-9247
- Phone
- (509) 529-3447
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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