Individual
JUSTIN PETTIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1748
(423) 282-9011
Mailing address
2410 SUSANNAH ST, JOHNSON CITY, TN 37601-1748
(423) 282-9011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6049
TN
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
07/12/2024
Last updated
07/12/2024
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