DR. Lisa Petty-Hartgrove, DBA

NPI #1366039588 in Kings Mountain, North Carolina

Provider Information

NPI Number: 1366039588
Entity Type: Individual
Name: DR. Lisa Petty-Hartgrove, DBA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Community Health Worker
Credential: DBA
Enumeration Date: Dec 22, 2020
Last Updated: Dec 22, 2020

Practice Location

Address: 1010 GROVES ST STE 2
City: Kings Mountain
State: North Carolina
ZIP Code: 28086-2230
Phone: (980) 404-1809

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X
Health Educator	174H00000X
Community Health Worker	172V00000X	Primary

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