Individual
CAROLINE ROSE PETTIJOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8600 N HICKORY ST, APT 512, KANSAS CITY, MO 64155-4103
(314) 608-1112
Mailing address
8600 N HICKORY ST, APT 512, KANSAS CITY, MO 64155-4103
(314) 608-1112
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1769
TN
Other
Enumeration date
07/16/2014
Last updated
07/16/2014
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