Individual
MR. DOUGLAS GENE PETTY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
500 N BALTIMORE ST, KIRKSVILLE, MO 63501-3214
(660) 665-7400
Mailing address
1410 E MEADOW LN, KIRKSVILLE, MO 63501-2654
(660) 627-0718
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
043669
MO
Other
Enumeration date
05/02/2006
Last updated
07/08/2007
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