MR. Kenneth C Petta, RPH

NPI #1871877373 in Troup, Texas

Provider Information

NPI Number: 1871877373
Entity Type: Individual
Name: MR. Kenneth C Petta, RPH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Oct 3, 2011
Last Updated: Oct 3, 2011

Practice Location

Address: 53 W TWIN CREEKS TRL
City: Troup
State: Texas
ZIP Code: 75789-6702
Phone: (903) 842-4209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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