MRS. Jessica Lea Petty, IDC
NPI #1407113111 in Jacksonville, North Carolina
Provider Information
- NPI Number
- 1407113111
- Entity Type
- Individual
- Name
- MRS. Jessica Lea Petty, IDC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Military Health Care Provider - Independent Duty Corpsman
- Credential
- IDC
- Enumeration Date
- Apr 19, 2012
- Last Updated
- Apr 19, 2012
Practice Location
- Address
- 194 MAREADY RD
- City
- Jacksonville
- State
- North Carolina
- ZIP Code
- 28546-9332
- Phone
- (904) 240-9350
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman |
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