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Individual
TIFFANY ROSE PETRY
Active
Individual
TIFFANY ROSE PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC212915
OR
225200000X
Physical Therapy Assistant
PTA9230
OR
225700000X
Massage Therapist
LMT-12041
—
Other
Enumeration date
01/10/2023
Last updated
05/08/2024
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