Individual
MR. TERRY LEE PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
16248 NE GLISAN ST, PORTLAND, OR 97230-5833
(503) 546-7543
(503) 255-7924
Mailing address
997 NW ASH CREEK LN, PORTLAND, OR 97229-5283
(503) 297-0597
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
272832
OR
Other
Enumeration date
04/04/2007
Last updated
10/09/2013
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