Organization
JAESEN PETRETTA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAESEN PETRETTA OTR/L (PRESIDENT)
(239) 839-3408
Entity
Organization
Contact information
Practice address
12995 S CLEVELAND AVE STE 158, FORT MYERS, FL 33907-3867
(239) 839-3408
Mailing address
4281 7TH AVE SW, NAPLES, FL 34119-4029
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
OT10199
FL
Other
Enumeration date
06/28/2013
Last updated
06/28/2013
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