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Individual

CHRISTY PETTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1923 APACHE AVE, SOUTH LAKE TAHOE, CA 96150-4821
(530) 854-0939
Mailing address
PO BOX 12282, ZEPHYR COVE, NV 89448-4282
(530) 854-0939

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
09/24/2024
Last updated
09/24/2024
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