Organization
JON M PETTIBON DC INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON M PETTIBON D.C. (OWNER)
(253) 752-3501
Entity
Organization
Contact information
Practice address
3837 S 12TH ST, TACOMA, WA 98405-2138
(253) 752-3501
(253) 752-3504
Mailing address
3837 S 12TH ST, TACOMA, WA 98405-2138
(253) 752-3501
(253) 752-3504
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1455
WA
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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