Petracca, Carmine John
Petracca, Carmine John is an individual health care provider with primary practice located at 939 Bryden , Lewiston ID 83501-5097. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Petracca, Carmine John can be contacted via phone (208) 743-1761.Contact Information
Primary practice address
939 Bryden
Lewiston ID 83501-5097
Phone: (208) 743-1761
Fax: (208) 746-8042
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP634 | Idaho |
Profile Details
| NPI number | 1457468613 |
|---|---|
| LBN Legal business name | Petracca, Carmine John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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