Organization
VALLEY ORTHOPAEDIC BONE AND JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN MATTHEW PETTEGREW D.O. (SURGEON/PARTNER)
(209) 572-3224
Entity
Organization
Contact information
Practice address
609 E ORANGEBURG AVE STE 201, MODESTO, CA 95350-5512
(209) 572-3224
(209) 572-4528
Mailing address
609 E ORANGEBURG AVE STE 201, MODESTO, CA 95350-5512
(209) 572-3224
(209) 572-4528
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
10/03/2018
Last updated
10/03/2018
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