Most Relevant Information
Provider Data
| NPI Number: | 1003572330 |
| Provider Name: | PHILLISCITA PETTY |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | 570107010254596 |
Most Important Dates
| Enumeration Date: | 11/10/2021 |
| Last Updated: | 11/12/2021 |
Provider Practice Location
1101 FM 2181
CORINTH
TX
762102136
Practice Location Phone/Fax
| Phone: | 9404971105 |
| Fax: |
Provider Mailing Location
1101 FM 2181
CORINTH
TX
762102136
Provider Mailing Phone/Fax
| Phone: | 9404971105 |
| Fax: |