Individual
MATTHEW C PETZNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2500 W STRUB RD, SUITE 230, SANDUSKY, OH 44870-5390
(419) 625-1200
(419) 625-0624
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 609-1112
(419) 609-1123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.009690
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3007249
—
OH
Enumeration date
11/15/2006
Last updated
12/13/2017
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