Individual
MR. JOHN ALTON PETTAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP C
Contact information
Practice address
2295 HENRY CLOWER BLVD, SUITE 101, SNELLVILLE, GA 30078
(770) 972-4871
(770) 979-3782
Mailing address
1105 PEBBLE BEND DRIVE, GRAYSON, GA 30017
(770) 985-2845
(770) 985-2845
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN107083 NP
GA
Other
Enumeration date
05/23/2006
Last updated
01/13/2009
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