Carmine Petracca
Carmine Petracca is a Health Service Clinic/Center in Lewiston, Idaho. Licensed in Idaho. Registered with an NPI since 2013.
- Licensed in
- ID
- In the registry since
- 2013
Practice location Address checks out
939 Bryden AveLewiston, ID 83501-5057
Phone: (208) 743-1761
Fax: (208) 746-8042
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Health Service Clinic/Center (primary) | Taxonomy 261QH0100X · Licence ODP-634 (ID) |
|---|
Record details
| NPI number | 1649601006 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Carmine Petracca — Owner · (208) 743-1761 |
| Other names | Bryden Family Vision |
| NPI enumerated | December 10, 2013 |
| Last updated in NPPES | December 10, 2013 |
| Mailing address | 939 Bryden Ave, Lewiston, ID 83501-5057 |