Individual
HEATHER ANNETTE PETROLLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
924 YOUNGSTOWN POLAND RD, STRUTHERS, OH 44471-1305
(330) 707-1360
(330) 707-1359
Mailing address
3507 CANFIELD RD, SUITE 7, YOUNGSTOWN, OH 44511-2859
(330) 793-0566
(330) 793-5767
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
36 00 1865 P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000134627
ANTHEM BLUE CROSS BLUE SH
—
01
—
000000134628
ANTHEM BLUE CROSS BLUE SH
—
01
—
000000134629
ANTHEM BLUE CROSS BLUE SH
—
05
—
0409543
—
OH
01
—
27 00142
UNITED HEALTHCARE
—
01
—
27 00411
UNITED HEALTHCARE
—
01
—
341581408 01
OHIO BUREAU OF WORTHERS C
—
01
—
341581408 02
OHIO BUREAU OF WORTHERS C
—
01
—
341581408009
MEDICAL MUTUAL
—
01
—
341581408011
MEDICAL MUTUAL
—
Enumeration date
08/16/2005
Last updated
03/06/2008
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