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1386150951
JERRELL PETTIGREW
COLUMBIA, SC
NPI
1386150951
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
(Licence: SC 17-32371)
Enumeration Date
2017-12-19
Last Update Date
2017-12-19
Business Address
JERRELL PETTIGREW
1048 WILDWOOD CENTRE DR
COLUMBIA, SC 29229-8420
Phone number: 803-999-3752
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Mailing Address
JERRELL PETTIGREW
181 W PROFESSIONAL PARK CT STE 1
BOWLING GREEN, KY 42104-3250
Phone number: 270-777-9283
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