Individual
MISS BRANDY ANNE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., ATC, LAT
Contact information
Practice address
GEORGIA SOUTHERN UNIVERSITY HANNER FIELDHOUSE, HERTY DRIVE, STATESBORO, GA 30460-0001
(912) 486-7581
(912) 486-7690
Mailing address
602 N KEVIN CT, STATESBORO, GA 30461-2743
(912) 486-7581
(912) 486-7690
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
AT001014
GA
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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