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1780998674
WANDA PETTYE
PARK FOREST, IL
NPI
1780998674
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: IL 043071327)
Enumeration Date
2010-08-03
Last Update Date
2010-08-03
Business Address
-- WANDA PETTYE
3618 WESTERN AVE
PARK FOREST, IL 60466-2126
Phone number: 708-228-0999
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Mailing Address
-- WANDA PETTYE
3618 WESTERN AVE
PARK FOREST, IL 60466-2126
Phone number: 708-228-0999
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