Organization
KURT S. PETRY OD, PC
Active
Parent organization
KURT S. PETRY OD, PC
Other names
Spencer Community Eyecare
Organization subpart
Yes
Provider details
NPI number
Legal business name
KURT S. PETRY OD, PC
Authorized official
KURT S PETRY O.D. (PRESIDENT)
(812) 829-2972
Entity
Organization
Contact information
Practice address
357C W MORGAN ST, SPENCER, IN 47460-1219
(812) 829-2972
Mailing address
357C W MORGAN ST, SPENCER, IN 47460-1219
(812) 829-2972
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002244B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000087919
BCBS
IN
05
—
100193710
—
IN
Enumeration date
05/21/2008
Last updated
03/01/2010
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