| Doctor Name: | JASON MICHAEL PETTY |
| NPI Number: | 1093075855 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | HIS |
| License Number: | 2748 |
| Business Practice Address: | 102 S East St Warrenton, MO - 633832014 |
| Business Phone Number: | 6364565454 |
| Business Fax Number: | 6364622702 |
| Mailing Address: | 6 Victory Drive, LIBERTY |
| State: | MO |
| Postal Code: | 64068 |
| Phone Number: | 8168832660 |
| Fax Number: | 8167929819 |
| NPI Enumeration Date: | 05/25/2012 |
| NPI Last Update Date: | 05/25/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 237700000X |
| License Number: | 2748 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Hearing Instrument Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Individuals who test hearing for the selection, adaptation, fitting, adjusting, servicing, and sale of hearing aids. Hearing Instrument Specialist is a designation provided individuals who qualify by the National Hearing Aid Society |