Pettyjohn, Joseph R

Pettyjohn, Joseph R is an individual health care provider with primary practice located at 7300 E Indiana St Ste 102, Evansville IN 47715-2794. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Pettyjohn, Joseph R can be contacted via phone (812) 476-0409.

Contact Information

Primary practice address
7300 E Indiana St Ste 102 Evansville IN 47715-2794
Phone: (812) 476-0409
Fax: (812) 476-1016
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05007273A Indiana

Profile Details

NPI number 1720062466
LBN Legal business name Pettyjohn, Joseph R
Credentials Master of Physical Therapy (MPT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 6th, 2005
Last updated Apr 16th, 2008 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1720062466 NPPES
Indiana Other 000000378767 BLUE CROSS BLUE SHIELD

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