Individual
MR. MARK PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2806 SCARLETT DR, AUGUSTA, GA 30909-2630
(706) 736-3392
Mailing address
2806 SCARLETT DR, AUGUSTA, GA 30909-2630
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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