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Individual

BREEANN MARIE PETRIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
431 E. MAIN ST. #994, CHALLIS, ID 83226-2713
(208) 833-1313
(833) 839-1195
Mailing address
431 E. MAIN ST., #994, CHALLIS, ID 83226
(208) 833-1313
(833) 839-1195

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA875
ID

Other

Enumeration date
11/10/2010
Last updated
03/21/2022
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