| Derry Petty, LMT | |
|
337 Oak Grove Ave Apt I, Jackson, MI 49203-1394 | |
| (517) 416-5297 | |
| Not Available |
| Full Name | Derry Petty |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 337 Oak Grove Ave Apt I, Jackson, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558812214 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 7501006216 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Derry Petty, LMT 337 Oak Grove Ave Apt I, Jackson, MI 49203-1394 Ph: (517) 416-5297 | Derry Petty, LMT 337 Oak Grove Ave Apt I, Jackson, MI 49203-1394 Ph: (517) 416-5297 |
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