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Organization
COMPREHENSIVE WOUND CARE
Active
Organization
COMPREHENSIVE WOUND CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH L PETTIT D.O (OWNER PHYSICIAN)
(480) 706-0174
Entity
Organization
Contact information
Practice address
16515 S 40TH ST, SUITE 139, PHOENIX, AZ 85048-0558
(480) 706-0174
(480) 706-0117
Mailing address
16515 S 40TH ST, SUITE 139, PHOENIX, AZ 85048-0558
(480) 706-0174
(480) 706-0117
Taxonomy
Speciality
Code
Description
License number
State
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887507
—
AZ
Enumeration date
07/13/2007
Last updated
06/21/2018
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