Individual
MRS. ELIZABETH G PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 E BLACKSTOCK RD, ROEBUCK, SC 29376-3206
(864) 576-6151
(864) 595-2429
Mailing address
2401 E BLACKSTOCK RD, ROEBUCK, SC 29376-3206
(864) 576-6151
(864) 595-2429
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P13063
SC
Other
Enumeration date
08/30/2013
Last updated
08/30/2013
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