Individual
DONALD PETTEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1222 10TH ST STE 211, WOODWARD, OK 73801-3156
(580) 256-8615
(580) 256-8643
Mailing address
1222 10TH ST STE 211, WOODWARD, OK 73801-3156
(580) 256-8615
(580) 256-8643
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24097
OK
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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