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Individual
DR. BRIAN RICHARD PETRIE
Active
Individual
DR. BRIAN RICHARD PETRIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1824
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1601580
—
MA
01
—
335503
TUFTS OUT OF NETWORK ID
MA
01
—
401417
BLUE CHIP RI ID NO
MA
01
—
4981-2
BC/BS RI PROVIDER NO
MA
01
—
Y36303
BC/BS OF MA PROVIDER NO
MA
01
—
ZY39272
BC/BS MA GROUP ID NO
MA
Enumeration date
10/13/2006
Last updated
05/08/2013
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