Derrick Dejuan Pettis

NPI #1265637847 in St Petersburg, Florida

Provider Information

NPI Number
1265637847
Entity Type
Individual
Name
Derrick Dejuan Pettis
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Emergency Medical Technician, Basic
Enumeration Date
Jun 15, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
600 8TH AVE SE
State
Florida
ZIP Code
33701-5030
Phone
(727) 502-1602

Specialties & Taxonomy Codes

Specialty
Emergency Medical Technician, Basic

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