MR. Glen Ross Pettenger, PA-C
NPI #1801910609 in Centerville, Texas
Provider Information
- NPI Number
- 1801910609
- Entity Type
- Individual
- Name
- MR. Glen Ross Pettenger, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant - Medical
- Credential
- PA-C
- Enumeration Date
- Mar 19, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 102 WEST MAIN STREET
- City
- Centerville
- State
- Texas
- ZIP Code
- 75833
- Phone
- (903) 536-2313
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Medical — Medical |
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