Individual
MRS. RACHEL L PETTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2016 S MAIN ST, MARYVILLE, MO 64468-2655
(660) 562-2600
Mailing address
305 TAYLOR ST, KING CITY, MO 64463-9537
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2003002524
MO
Other
Enumeration date
05/29/2007
Last updated
07/08/2007
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