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Individual

ROMAN TOBIAS PETTIGREW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1015 NW 22ND AVE, PORTLAND, OR 97210-3025
(503) 413-8401
Mailing address
5 NASONS CT STE 8, KENNEBUNK, ME 04043-7293

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
03/29/2023
Last updated
03/29/2023
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