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1407113111
JESSICA LEA PETTY
JACKSONVILLE, NC
NPI
1407113111
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2012-04-19
Last Update Date
2012-04-19
Business Address
Mrs. JESSICA LEA PETTY IDC
194 MAREADY RD
JACKSONVILLE, NC 28546-9332
Phone number: 904-240-9350
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Mailing Address
Mrs. JESSICA LEA PETTY IDC
PSC BOX 20125 CLR-27 GROUP AID STATION
CAMP LEJEUNE, NC 28542-0125
Phone number: 904-240-3350
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