Individual
LIDIA PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1760 N DECATUR BLVD, 79, LAS VEGAS, NV 89108-2208
(702) 810-9742
Mailing address
1760 N DECATUR BLVD, 79, LAS VEGAS, NV 89108-2208
(702) 810-9742
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
12/18/2013
Last updated
12/18/2013
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