Individual
ANDREW JOHN PETULLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
2048 LINCOLN AVE, SAN JOSE, CA 95125-3449
(408) 448-1677
(408) 448-7060
Mailing address
2048 LINCOLN AVE, SAN JOSE, CA 95125-3449
(408) 448-1677
(408) 448-7060
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT15558
CA
Other
Enumeration date
07/28/2006
Last updated
07/08/2007
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