Individual
MR. MARK NOEL PETTUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
14631 FLOYD ST, OVERLAND PARK, KS 66223-2244
(913) 486-2207
(913) 897-0248
Mailing address
14631 FLOYD ST, OVERLAND PARK, KS 66223-2244
(913) 486-2207
(913) 897-0248
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-01203
KS
Other
Enumeration date
12/08/2011
Last updated
12/08/2011
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