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Mark Pettis, PTA
NPI 1982884524 · on the registry since 2007 · sole proprietor
Practice
- Address
- 203 Stanley Ct
La Porte, IN 46350 - Phone
- (219) 362-2744
Registry record
- Primary taxonomy
- Community Health Worker
172V00000X
- Licence states on file
- IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2008-08-25
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana