Individual
KELCIE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 W 1325 N STE 200, CEDAR CITY, UT 84721-8179
(435) 586-7676
Mailing address
110 W 1325 N STE 200, CEDAR CITY, UT 84721-8179
(435) 586-7676
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14139610-1206
UT
Other
Enumeration date
04/20/2022
Last updated
08/24/2024
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