SAM L PETTIBON

FEDERAL WAY, WA
NPI1386860492
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy111NR0400X 
(Licence: WA  2174)
Enumeration Date2007-04-17
Last Update Date2012-05-02
Business Address
-- SAM L PETTIBON D.O.
30804 PACIFIC HWY S
FEDERAL WAY, WA 98003-4902
Phone number: 253-839-5644
Mailing Address
-- SAM L PETTIBON D.O.
30804 PACIFIC HWY S
FEDERAL WAY, WA 98003-4902
Phone number: 253-839-5644
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