Individual
ALEXIS PETTWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
13847 EARLHAM DRIVE, WHITTIER, CA 90602
(562) 907-4200
Mailing address
2118 N PALM AVE, RIALTO, CA 92377-4624
(909) 562-5534
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000007378
NE
Other
Enumeration date
08/14/2019
Last updated
08/14/2019
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