Brenda L Petticrew, LMT Valid NPI
Individual provider · Specialist · Shannon, IL
- NPI
- 1568810331
- Type
- Individual (Type 1)
- Primary specialty
- Specialist
- Specialty group
- Other Service Providers
- Taxonomy code
- 174400000X
- License number
- 227.016348 (IL)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2016-06-02
- Last updated
- 2016-06-02
Practice location
409 S Hickory St
Shannon, IL 61078-9017
(815) 238-2588