Individual
JESSICA LYNN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
12826 DAYLIGHT CIR, SAINT LOUIS, MO 63131-1890
(314) 328-0441
Mailing address
1450 HARNESS RD, FESTUS, MO 63028-5402
(636) 524-2322
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2016037457
MO
Other
Enumeration date
06/07/2019
Last updated
06/07/2019
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