Individual
MRS. DEANN PETITGOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
1550 CLARKE DR, MS 1757, DUBUQUE, IA 52001-3117
(563) 588-6415
(563) 588-6666
Mailing address
609 SHERWOOD AVE, EAST DUBUQUE, IL 61025-1151
(815) 747-9922
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00226
IA
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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