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RYAN LEE PETTET P.T.A.

>> Physical Therapy Assistant >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1144418351

Individual Registrant:
 RYAN LEE PETTET P.T.A.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
616 E 13TH ST  WINAMAC, IN 46996-1117 US
Tel: 574-946-2157  Fax: --

Contact information for business:
616 E 13TH ST  WINAMAC, IN 46996-1117 US
Tel: 574-946-2157  Fax: --

Registration Information:
NPI: 1144418351
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225200000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapy Assistant
IN06003445A

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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