Doctor Name: | DR. L. RANDY PETTIT |
NPI Number: | 1841351152 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | DC009220 |
Business Practice Address: | 1412 Jefferson Road Jefferson, PA - 15344 |
Business Phone Number: | 7248833733 |
Business Fax Number: | 7248834766 |
Mailing Address: | P. O. Box 211, 1412 Jefferson Road JEFFERSON |
State: | PA |
Postal Code: | 15344 |
Phone Number: | 7248833733 |
Fax Number: | 7248834766 |
NPI Enumeration Date: | 12/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC009220 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |