Individual
JOHN LEE PETTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
IDC
Contact information
Practice address
881 USS JAMES MADISON ROAD, BRANCH HEALTH CLINIC KINGS BAY, KINGS BAY, GA 31547-2531
(912) 573-2938
Mailing address
881 USS JAMES MADISON ROAD, BRANCH HEALTH CLINIC KINGS BAY, KINGS BAY, GA 31547-2531
(912) 573-2938
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
10/08/2010
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