Individual
TAKANA PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 BARBERRY LN, PEACHTREE CITY, GA 30269-6913
(678) 472-0394
Mailing address
1227 BARBERRY LN, PEACHTREE CITY, GA 30269-6913
(678) 472-0394
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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