Individual
JENNIFER LYNN PETTUSJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 W MAPLE ST, STILWELL, OK 74960-3100
(918) 708-3006
(918) 777-9016
Mailing address
110 W MAPLE ST, STILWELL, OK 74960-3100
(918) 708-3006
(918) 777-9016
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/19/2018
Last updated
02/05/2018
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