MISTY SUSANNE PETRO PTAATCCSCS NPI 1013174051

NPI Information

Misty Susanne Petro, PTA,ATC,CSCS is a specialist in Bloomington, IN. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Misty Susanne Petro, PTA,ATC,CSCS NPI is 1013174051. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1355 W BLOOMFIELD RD STE B
BLOOMINGTON, IN
ZIP 47403-052
Phone: (812) 336-7910

The enumeration date for this NPI number is 5/19/2008 and was last updated on 5/19/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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