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Individual

DR. DAVID JAMES PETRIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
NAVAJO ROUTE 4, PINON HEALTH CENTER, PINON, AZ 86510
(928) 725-3220
(928) 725-3613
Mailing address
PO BOX PH, CHINLE, AZ 86503-8000
(928) 674-7166

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG002563
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
102711443
PA
Enumeration date
12/23/2010
Last updated
02/18/2016
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