Carly Petrie, PA

NPI #1265158810 in Meridian, Idaho

Provider Information

NPI Number
1265158810
Entity Type
Individual
Name
Carly Petrie, PA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant - Surgical
Credential
PA
Enumeration Date
Oct 17, 2022
Last Updated
Nov 11, 2022

Practice Location

Address
520 S EAGLE RD STE 1241
State
Idaho
ZIP Code
83642-6355
Phone
(208) 381-6930

Specialties & Taxonomy Codes

Specialty
Physician Assistant - SurgicalSurgical

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