Individual
MARY A PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
693 LEESVILLE RD, LYNCHBURG, VA 24502-2828
(434) 200-5750
Mailing address
3300 RIVERMONT AVE, LYNCHBURG, VA 24503-2030
(434) 200-5032
(434) 200-1294
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119005118
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396706065
—
VA
01
—
496612
MEDICARE
—
Enumeration date
05/27/2010
Last updated
12/18/2024
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