Organization
THOMAS C. PETRIE, C.D.N.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS CHARLES PETRIE C.D.N. (NUTRITIONIST)
(518) 490-1720
Entity
Organization
Contact information
Practice address
20 WASHINGTON ST, BALLSTON SPA, NY 12020-1761
(518) 879-5877
Mailing address
110 BROOKLINE RD, APT. B-11, BALLSTON SPA, NY 12020-3527
(518) 879-5877
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
003560
NY
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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