Individual
MR. JAMES PAUL PETROCHKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
175 S WILKES BARRE BLVD, WILKES BARRE, PA 18702-5040
(570) 200-7510
(570) 200-7509
Mailing address
308 CEDAR MANOR DR, MOUNTAIN TOP, PA 18707-1541
(570) 474-0567
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP-033941-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP-033941-L
PHARMACIST
PA
Enumeration date
03/20/2007
Last updated
07/08/2007
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