Individual
JOSEPH W PETRIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
431 E. MAIN ST., #994, CHALLIS, ID 83226
(208) 833-3773
(833) 839-1175
Mailing address
431 E. MAIN ST., #994, CHALLIS, ID 83226
(208) 833-1313
(833) 839-1175
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1129
ID
Other
Enumeration date
11/18/2013
Last updated
02/02/2022
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