Individual
VITALIY PETRYSHCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SA-C
Contact information
Practice address
800 W CENTRAL RD, ARLINGTON HEIGHTS, IL 60005-2349
(678) 983-4479
(678) 690-8160
Mailing address
PO BOX 543, ALPHARETTA, GA 30009-0543
(678) 983-4479
(678) 690-8160
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
04/04/2011
Last updated
09/01/2011
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