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Individual
MR. STEVEN ALAN PETRARCA
Active
Individual
MR. STEVEN ALAN PETRARCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OST CPED
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
29672
BLUE CROSS
—
01
—
408288
BLUE CHIP
—
Enumeration date
05/24/2007
Last updated
07/08/2007
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