Individual
RYAN LEE PETTET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.A.
Contact information
Practice address
616 E 13TH ST, WINAMAC, IN 46996-1117
(574) 946-2157
Mailing address
616 E 13TH ST, WINAMAC, IN 46996-1117
(574) 946-2157
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06003445A
IN
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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