Individual
JOHN JULES PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6701 W LEOPOLD LOOP, WASILLA, AK 99623-9834
(907) 231-0843
Mailing address
6701 W LEOPOLD LOOP, WASILLA, AK 99623-9834
(907) 231-0843
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
AK
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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