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1659454544
KELLY R PETTIT
REDMOND, OR
NPI
1659454544
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NM MD2006-0194)
Enumeration Date
2006-10-23
Last Update Date
2022-07-01
Business Address
KELLY R PETTIT MD
1253 NW CANAL BLVD
REDMOND, OR 97756-1334
Phone number: 541-548-8131
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Mailing Address
KELLY R PETTIT MD
275 E 200 S
SALT LAKE CITY, UT 84111-2002
Phone number: 800-366-1884
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