Individual
ETHAN PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
175 N 100 W, STE 106, VERNAL, UT 84078-2049
(435) 789-9060
(435) 781-3048
Mailing address
175 N 100 W, STE 106, VERNAL, UT 84078-2049
(435) 789-9060
(435) 781-3048
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
R-8712
IA
Other
Enumeration date
06/09/2009
Last updated
02/06/2014
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