| Doctor Name: | DR. KRISTIE PETREE |
| NPI Number: | 1083053201 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 5101020747 |
| Business Practice Address: | 4660 S Hagadorn Rd Suite 500 East Lansing, MI - 488235376 |
| Business Phone Number: | 5174326144 |
| Business Fax Number: | 5174326150 |
| Mailing Address: | 965 Fee Road, Room A 439 EAST LANSING |
| State: | MI |
| Postal Code: | 488241316 |
| Phone Number: | 5173539110 |
| Fax Number: | 5173530789 |
| NPI Enumeration Date: | 06/20/2013 |
| NPI Last Update Date: | 05/07/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204D00000X |
| License Number: | 5101020747 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Neuromusculoskeletal Medicine & OMM |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |