Jerry Pettus

NPI #1427591205 in Galena, Kansas

Provider Information

NPI Number: 1427591205
Entity Type: Individual
Name: Jerry Pettus
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Nov 28, 2016
Last Updated: Nov 28, 2016

Practice Location

Address: 444 FOUR STATES DR.
Address 2: STE 1
City: Galena
State: Kansas
ZIP Code: 66739-4325
Phone: (620) 783-4441

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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