Most Relevant Information
Provider Data
| NPI Number: | 1003332578 |
| Provider Name: | ADAM J PETTY LAC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | LAC-16151 |
Most Important Dates
| Enumeration Date: | 08/16/2017 |
| Last Updated: | 08/16/2017 |
Provider Practice Location
1825 E NORTHERN AVE STE 215
PHOENIX
AZ
850203940
Practice Location Phone/Fax
| Phone: | 4803605484 |
| Fax: |
Provider Mailing Location
2618 E GENEVA DR
TEMPE
AZ
852824152
Provider Mailing Phone/Fax
| Phone: | 4803823124 |
| Fax: |