Individual
MARYLENA JUANNA PETTIGREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1289 FIRETHORNE DR, MASON, OH 45040-1184
(513) 919-3972
Mailing address
1289 FIRETHORNE DR, MASON, OH 45040-1184
(513) 919-3972
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401593141213
OH
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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