Individual
ALEX JOSEPH PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
202 S WASHITA AVE, WYNNEWOOD, OK 73098-7820
(405) 665-4385
Mailing address
36703 E COUNTY ROAD 1590, PAULS VALLEY, OK 73075-9604
(405) 207-6621
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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