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Individual

DR. MICHAEL STEPHEN PETTERUTO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
234 CHAPLIN DR, COVENTRY, RI 02816
(401) 392-3351
(401) 392-3051
Mailing address
234 CHAPLIN DR, COVENTRY, RI 02816
(401) 392-3351
(401) 392-3051

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DCP00383
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
21331430
AETNA
RI
01
2822-8
BLUE CROSS
RI
01
404806
BLUE CHIP
RI
01
6152953
CIGNA
RI
Enumeration date
05/24/2006
Last updated
07/08/2007
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