Individual
MR. EDWARD K PETRUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
444 COLLETT BRIDGE RD, ALVATON, KY 42122-9675
(270) 842-0433
Mailing address
444 COLLETT BRIDGE RD, ALVATON, KY 42122-9675
(270) 842-0433
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
820A
KY
Other
Enumeration date
05/23/2005
Last updated
04/11/2013
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