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Individual

PAUL DAVID PETRY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1030 MCINTOSH CIR STE 1, JOPLIN, MO 64804-3690
(417) 347-8750
Mailing address
PO BOX 3810, JOPLIN, MO 64803-3810
(417) 347-3474

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
111311
MO

Other

Enumeration date
07/12/2006
Last updated
03/14/2024
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