Pettine, Kenneth A
Pettine, Kenneth A is an individual health care provider with primary practice located at 4795 Larimer Parkway , Johnstown CO 80534. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine, which is considered as his primary health care specialty. Pettine, Kenneth A can be contacted via phone (970) 669-8881.Contact Information
Primary practice address
4795 Larimer Parkway
Johnstown CO 80534
Phone: (970) 669-8881
Fax: (970) 669-4200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery of the Spine | 207XS0117X | 29524 | Colorado |
Profile Details
| NPI number | 1720069198 |
|---|---|
| LBN Legal business name | Pettine, Kenneth A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 10th, 2005 |
| Last updated | Mar 23rd, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720069198 | NPPES |
| Colorado | MEDICAID | 01295245 |
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