Individual
MR. GREGORY WAYNE PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICAL THERAPIST
Contact information
Practice address
2071 S ALABAMA AVE, MONROEVILLE, AL 36460-8681
(251) 575-1933
(251) 575-2807
Mailing address
14114 ALABAMA STREET, JAY, FL 32565
(850) 675-8040
(850) 675-8016
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2257
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-33361
BLUE CROSS
AL
Enumeration date
06/12/2006
Last updated
07/19/2017
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