Leo Dillon Pettit
Massage Therapist
10823 E Palmer Wasilla Hwy Ste 4
Palmer
, Alaska 99645-9498
Leo Dillon Pettit
Massage Therapist
10823 E Palmer Wasilla Hwy Ste 4
Palmer
, Alaska 99645-9498
(907) 707-3847
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About
Features
Specialties
- Massage Therapist
Languages spoken
- English
Location
First Address
- Leo Dillon Pettit
- 10823 E Palmer Wasilla Hwy Ste 4
- Palmer, AK
- Zip : 99645-9498
- Phone : (907) 707-3847
Second Address
- Leo Dillon Pettit
- 10823 E Palmer Wasilla Hwy Ste 4
- Palmer, AK
- Zip : 99645-9498
- Phone : (907) 707-3847
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 133088 | AK |
National Provider Identifier
| NPI | 1003392812 |
|---|---|
| Provider Name | Leo Dillon Pettit |
| First Address | Palmer, AK 99645-9498 |
| Second Address | Palmer, AK 99645-9498 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/07/2018 |
| Last Update Date | 03/02/2022 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.