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Individual

VIRGINIA LOLA PETTIGREW-WHEATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3976 KING GRAVES RD, 910TH MDS (AFRC), VIENNA, OH 44473-6900
(330) 609-1233
Mailing address
3976 KING GRAVES RD, 910TH MDS (AFRC), VIENNA, OH 44473-6900
(330) 609-1233

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
07/22/2009
Last updated
07/22/2009
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