MEDICARE: BARBARA PETRIE OTR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1194051631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA PETRIE OTR

Provider Business Mailing Address
First Line	:	182 DIANE AVE
Second Line	:
City	:	SOUTH YARMOUTH
State	:	MA
Zip	:	02664-1922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	182 DIANE AVE
Second Line	:
City	:	SOUTH YARMOUTH
State	:	MA
Zip	:	02664-1922
Country	:	US
Telephone Number	:	508-398-2158
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2009
Last Update Date	:	03/28/2015

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Directions to “ BARBARA PETRIE OTR” Practice Location

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