Individual
DR. SCOTT W. PETRALLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4241 KIRK RD, YOUNGSTOWN, OH 44511-1839
(330) 793-0711
(330) 793-9419
Mailing address
4241 KIRK RD, YOUNGSTOWN, OH 44511-1839
(330) 793-0711
(330) 793-9419
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3292
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1547116
GATEWAY (MEDICAID
OH
05
—
2305697
—
OH
Enumeration date
10/11/2006
Last updated
05/23/2016
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