Individual
DIANNE M PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DIETITIAN
Contact information
Practice address
405 MONROE ST, PELLA, IA 50219-1189
(641) 628-3832
(641) 628-8894
Mailing address
405 MONROE ST, PELLA, IA 50219-1189
(641) 628-3832
(641) 628-8894
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16915
AMERICAN DIETETIC ASSOC.
—
Enumeration date
04/01/2008
Last updated
04/01/2008
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