NPI 1013174051

Misty Susanne Petro, PTAATCCSCS

Practitioner Specialist Bloomington, IN

Practice location

Address: 1355 W Bloomfield Rd STE B, Bloomington, IN 47403-2052
Phone: (812) 336-7910

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 99032299A (IN)

Other Specialist providers in Indiana →

Registry record

NPI: 1013174051
Entity type: Individual
Sex (as registered): Female
NPI issued: 19 May 2008
Record last updated: 19 May 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.