Individual
TRACY LETICIA PETRILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
218 E BLACKSTOCK RD, SPARTANBURG, SC 29301-2607
(864) 576-8646
Mailing address
618 ELWOOD DRIVE, DUNCAN, SC 29334
(407) 257-6988
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4263
SC
Other
Enumeration date
01/28/2022
Last updated
02/01/2022
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