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Individual

DR. BRIAN RICHARD PETRIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
575 SOUTH ST W, UNIT 2, RAYNHAM, MA 02767-5305
(508) 821-4049
(508) 821-2526
Mailing address
575 SOUTH ST W, UNIT 2, RAYNHAM, MA 02767-5305
(508) 821-4049
(508) 821-2526

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1824
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1601580
MA
01
335503
TUFTS OUT OF NETWORK ID
MA
01
401417
BLUE CHIP RI ID NO
MA
01
4981-2
BC/BS RI PROVIDER NO
MA
01
Y36303
BC/BS OF MA PROVIDER NO
MA
01
ZY39272
BC/BS MA GROUP ID NO
MA
Enumeration date
10/13/2006
Last updated
05/08/2013
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