Pettis, Mark E

Pettis, Mark E is an sole proprietor health care provider with primary practice located at 203 Stanley Ct , La Porte IN 46350-4159. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Pettis, Mark E can be contacted via phone (219) 362-2744.

Contact Information

Primary practice address
203 Stanley Ct La Porte IN 46350-4159
Phone: (219) 362-2744
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X 06003247A Indiana

Profile Details

NPI number 1982884524
LBN Legal business name Pettis, Mark E
Credentials Physical Therapist Assistant (PTA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 12th, 2007
Last updated Aug 25th, 2008 - about 17 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.

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