Individual
MICHAEL KEITH PETITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
605 MAIN STREET, SHARPSBURG, KY 40374
(606) 336-0246
Mailing address
PO BOX 208, SHARPSBURG, KY 40374-0208
(606) 336-0246
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
165118
KY
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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