Individual
FRED E PETRUNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1418 11TH AVENUE, ALTOONA, PA 16601
(814) 946-3937
(814) 946-3937
Mailing address
1418 11TH AVENUE, ALTOONA, PA 16601
(814) 946-3937
(814) 944-8265
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000566
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014776200002
—
PA
Enumeration date
05/03/2006
Last updated
12/03/2013
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