Individual
MRS. STACY LYN PETKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
414 S UNIVERSITY RD, SPOKANE VALLEY, WA 99206-5555
(509) 924-4650
(509) 228-0851
Mailing address
3417 E 30TH AVE, SPOKANE, WA 99223-3741
(509) 924-4650
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
WA
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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