Individual
ALYSHA PETTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1829 FOREST GLEN DR, FRUITLAND PARK, FL 34731-6565
(352) 818-2485
Mailing address
1829 FOREST GLEN DR, FRUITLAND PARK, FL 34731-6565
(352) 818-2485
Taxonomy
Speciality
Code
Description
License number
State
246R00000X
Pathology Technician
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
05/07/2021
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