Individual
MR. AARON DEWAYNE PETREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
475 N HIGHWAY 25 W STE 100, WILLIAMSBURG, KY 40769-1576
(606) 549-2930
Mailing address
PO BOX 247, JELLICO, TN 37762-0247
(423) 784-0269
(423) 784-3708
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA2574
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100652600
—
KY
05
—
Q056813
—
TN
Enumeration date
12/18/2019
Last updated
12/05/2024
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