Individual
MARY ELIZABETH PETAISTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MASSAGE THERAPIST
Contact information
Practice address
1000 COUNTRY LN STE 400, ISHPEMING, MI 49849-3410
(906) 486-2000
Mailing address
2083 WRIGHT ST, MARQUETTE, MI 49855-1465
(906) 204-9666
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501004610
MI
Other
Enumeration date
10/11/2022
Last updated
10/11/2022
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