Individual
JAMES PETTAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7338 BROCKTON RD, PHILADELPHIA, PA 19151-2238
(267) 934-0368
Mailing address
7338 BROCKTON RD, PHILADELPHIA, PA 19151-2238
(267) 934-0368
Taxonomy
Speciality
Code
Description
License number
State
171WH0202X
Home Modifications Contractor
Primary
—
—
Other
Enumeration date
08/17/2016
Last updated
08/17/2016
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