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Organization
PETTIT PEDIATRICS LLC
Active
Organization
PETTIT PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ETHAN C PETTIT DO (OWNER)
(435) 299-0593
Entity
Organization
Contact information
Practice address
1360 W HIGHWAY 40, VERNAL, UT 84078-4203
(435) 789-7337
(435) 789-7338
Mailing address
3431 W 500 N, VERNAL, UT 84078-9710
(435) 781-8897
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
11/08/2018
Last updated
03/27/2019
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