Individual
BRUCE ALLEN PETKOVSEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
3600 KOLBE RD, LORAIN, OH 44053-1654
(440) 960-3420
(440) 960-3908
Mailing address
3600 KOLBE RD, LORAIN, OH 44053-1654
(440) 960-3420
(440) 960-3908
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03113613
OH
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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