Individual
DORIS JEAN PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 WANDA, MARIETTA, OK 73448
(580) 276-3323
(580) 276-3324
Mailing address
2021 4TH AVE NW TRLR 77, ARDMORE, OK 73401-2529
(580) 276-3323
(580) 276-3324
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0027558
OK
Other
Enumeration date
06/27/2007
Last updated
07/08/2007
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