Individual
DR. MARK JAMES PETRYKOWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1494 W MAIN ST, NEWARK, OH 43055-1825
(740) 344-4747
Mailing address
1494 W MAIN ST, NEWARK, OH 43055-1825
(740) 344-4747
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4222
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0934958
—
OH
Enumeration date
05/03/2006
Last updated
06/09/2011
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