Individual
HOLLY JO PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
801 LAKEFIELD DR, GALLOWAY, OH 43119-9020
(614) 638-7383
Mailing address
801 LAKEFIED DRIVE, GALLOWAY, OH 43119
(614) 638-7383
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN118067 M-IV
OH
Other
Enumeration date
04/11/2012
Last updated
04/11/2012
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