MR. Mark E Pettis, PTA

NPI #1982884524 in La Porte, Indiana

Provider Information

NPI Number
1982884524
Entity Type
Individual
Name
MR. Mark E Pettis, PTA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Community Health Worker
Credential
PTA
Enumeration Date
Nov 12, 2007
Last Updated
Aug 25, 2008

Practice Location

Address
203 STANLEY CT
State
Indiana
ZIP Code
46350-4159
Phone
(219) 362-2744

Specialties & Taxonomy Codes

Specialty
Community Health Worker

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