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Individual
MICHAEL J PETTELLA
Active
Individual
MICHAEL J PETTELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH0006496
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
350052194
RAILROAD MEDICARE
FL
Enumeration date
10/28/2005
Last updated
10/04/2012
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