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Individual

JAN KAREL PETRIC

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CO

Contact information

Practice address
6011 HARRY HINES BLVD, DALLAS, TX 75235-5386
(214) 645-8250
Mailing address
3030 HESTER AVE APT 509, DALLAS, TX 75205-3673

Taxonomy

Speciality
Code
Description
License number
State
222Z00000X
Orthotist
2128
TX
224P00000X
Prosthetist
Primary
2128
TX

Other

Enumeration date
02/02/2023
Last updated
02/02/2023
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