MR. Jeremy Thomas Pettinger, MPT

NPI #1700916087 in Grangeville, Idaho

Provider Information

NPI Number: 1700916087
Entity Type: Individual
Name: MR. Jeremy Thomas Pettinger, MPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MPT
Enumeration Date: Mar 6, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 126 E MAIN ST
City: Grangeville
State: Idaho
ZIP Code: 83530-2211
Phone: (208) 406-5195

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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