Individual
ALLY PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
735 JOHN R RD, TROY, MI 48083-5856
(248) 951-0000
Mailing address
735 JOHN R RD STE 150, TROY, MI 48083-5859
(248) 588-9300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005425
MI
152W00000X
Optometrist
6574
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0279325
—
OH
05
—
1487173514
—
MI
Enumeration date
09/09/2017
Last updated
07/21/2022
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