Individual
NINA PETROSYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
320 E 2ND ST, LIBBY, MT 59923-2010
(406) 283-6900
Mailing address
OFFICE OF STUDENT AFFAIRS 1975 ZONAL AVE, LOS ANGELES, CA 90089-0001
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
142023
MT
390200000X
Student in an Organized Health Care Education/Training Program
TL.0008739
CO
Other
Enumeration date
04/06/2020
Last updated
08/30/2024
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