Organization
RENOVATION CHIROPRACTIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN JEREMY PETTYGROVE DC (PROVIDER/PRESIDENT)
(478) 334-7958
Entity
Organization
Contact information
Practice address
3035 WATSON BLVD, SUITE 5, WARNER ROBINS, GA 31093-9526
(770) 982-4886
(770) 979-2275
Mailing address
3035 WATSON BLVD, SUITE 5, WARNER ROBINS, GA 31093-9526
(770) 982-4886
(770) 979-2275
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO009223
GA
Other
Enumeration date
02/12/2014
Last updated
05/05/2014
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