Individual
ELIZABETH J PETELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1318 KANSAS DR, PAOLA, KS 66071-2107
(913) 557-5678
(913) 557-5681
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-8678
(515) 643-5802
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
05-47905
KS
Other
Enumeration date
06/04/2020
Last updated
12/12/2023
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