Individual
MS. KRYSTALLYNN MARIE PETWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3487 S LINDEN RD, FLINT, MI 48507-3025
(866) 498-3909
Mailing address
1671 CHRISTOPHER DR, CANTON, MI 48188-1774
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703128130
MI
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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