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Individual

MR. ROBERT WILLIAM PETRUSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BA

Contact information

Practice address
937 PARK AVE, MEADVILLE, PA 16335-3334
(814) 724-6211
Mailing address
937 PARK AVE, MEADVILLE, PA 16335-3334
(814) 724-6211

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
F02267
PA
237700000X
Hearing Instrument Specialist
Primary
F02267
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01943398
PA
Enumeration date
01/18/2007
Last updated
04/01/2008
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