Individual
MICHAEL TODD PETTIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
2508 W BROADWAY, COUNCIL BLUFFS, IA 51501-3509
(712) 328-2266
(712) 328-9063
Mailing address
2508 W BROADWAY, COUNCIL BLUFFS, IA 51501-3509
(712) 328-2266
(712) 328-9063
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10065
NE
183500000X
Pharmacist
Primary
15543
IA
Other
Enumeration date
11/19/2011
Last updated
11/19/2011
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