Individual
AMY MARIE PETRUNAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
500 GYPSY LN, YOUNGSTOWN, OH 44504-1315
(330) 747-6700
Mailing address
112 ROCKY LEDGE DR, STRUTHERS, OH 44471-1466
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
35068169P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2029576
—
OH
01
—
942460636338
CARESOURCE
OH
Enumeration date
07/21/2006
Last updated
07/08/2007
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