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1801287610
AMY DIETZEN PETTICREW
CHARLOTTE, NC
NPI
1801287610
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Former Name
AMY ELIZABETH DIETZEN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 0010-05569)
Enumeration Date
2015-02-16
Last Update Date
2023-04-26
Business Address
Mrs. AMY DIETZEN PETTICREW PA-C
6324 FAIRVIEW RD SUITE 201
CHARLOTTE, NC 28210-3271
Phone number: 704-384-0588
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Mailing Address
Mrs. AMY DIETZEN PETTICREW PA-C
PO BOX 60447 SUITE 200
CHARLOTTE, NC 28260-0447
Phone number: 704-384-0588
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