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Misty Susanne Petro, PTA,ATC,CSCS
Specialist in Bloomington, Indiana
NPI 1013174051

Misty Susanne Petro is a Specialist based in Bloomington, IN. Misty Susanne Petro practices in Bloomington, IN and has the professional credentials of PTA,ATC,CSCS. The NPI Number for Misty Susanne Petro is 1013174051 and holds a License No. 99032299A (Indiana).

The current practice location address for Misty Susanne Petro is 1355 W Bloomfield Rd Ste B, Bloomington, IN and can be reached out via phone at 812-336-7910.

Location: 1355 W Bloomfield Rd Ste B, Bloomington, IN, 47403-2052
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1013174051
Provider Name
Misty Susanne Petro
Credential
PTA,ATC,CSCS
Provider Entity Type
Individual
Gender
Female
Address
1355 W Bloomfield Rd Ste B, Bloomington, IN, 47403-2052
Phone Number
812-336-7910
Fax Number
Provider Enumeration Date
05/19/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1355 W Bloomfield Rd Ste B
City
Bloomington
State
Indiana
Zip
47403-2052
Phone Number
812-336-7910
Fax Number
person
Provider Business Mailing Address Details
Address
1355 W Bloomfield Rd Ste B
City
Bloomington
State
Indiana
Zip
47403-2052
Phone Number
812-336-7910
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
99032299A (Indiana)
Definition
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.
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