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Individual

MR. SCOTT MICHAEL PETHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, BSN, RN

Contact information

Practice address
2700 W 9TH AVE, SUITE 107, OSHKOSH, WI 54904-7247
(920) 236-1835
(920) 223-1182
Mailing address
2700 W 9TH AVE, SUITE 107, OSHKOSH, WI 54904-7247
(920) 236-1835
(920) 223-1182

Taxonomy

Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
136064-30
WI

Other

Enumeration date
03/02/2012
Last updated
03/02/2012
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