Individual
TERRIE RENA PETTIGREW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2250 E FLAMINGO RD, LAS VEGAS, NV 89119-5170
(702) 784-4300
Mailing address
2250 E FLAMINGO RD, LAS VEGAS, NV 89119-5170
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1068
NV
Other
Enumeration date
05/20/2011
Last updated
05/20/2011
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