Organization · Type 2 NPI
Carmine Petracca
Health Service Clinic/Center · Lewiston, ID
NPI number
1649601006
Active
Practice location
939 Bryden Ave
Lewiston, ID 83501-5057
Fax (208) 746-8042
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center Primary | 261QH0100X | ODP-634 (ID) |
Health Service Clinic/Center: Definition to come...
5 other providers at this address
- Bryden Family VisionOptometrist Lewiston, ID NPI 1558752204
- Randy L. Sorensen DMD PADentist Lewiston, ID NPI 1932119161
- James E. Pierce, DDSDentist Lewiston, ID NPI 1013910371
- Jason Scott RitterOptometrist Lewiston, ID NPI 1588071633
- Randy Lee Sorensen, DMDGeneral Practice Dentistry Lewiston, ID NPI 1124037924
About NPI 1649601006
Carmine Petracca's National Provider Identifier is 1649601006, issued on Dec 10, 2013. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Lewiston, ID. The record was last updated on Dec 10, 2013.