Individual
MS. REBECCA LYNN PETTICORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
1790 HAMILL RD, HIXSON, TN 37343-4905
(423) 842-9322
(866) 591-0619
Mailing address
1790 HAMILL RD, HIXSON, TN 37343-4905
(423) 842-9322
(866) 591-0619
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT0000004081
TN
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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