Search › Idaho › 152W00000X
Carmine Petracca, OD
NPI 1457468613 · on the registry since 2006
Practice
- Address
- 939 Bryden
Lewiston, ID 83501 - Phone
- (208) 743-1761
- Fax
- (208) 746-8042
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho