Individual
PRECIOUS A PETTAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3624 RUSSIAN OLIVE ST, NORTH LAS VEGAS, NV 89032-7643
(702) 353-1079
Mailing address
3624 RUSSIAN OLIVE ST, NORTH LAS VEGAS, NV 89032-7643
(702) 353-1079
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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