Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 881 | MT |
N | 2251E1200X | Ergonomics | 881 | MT |
N | 225XE1200X | Ergonomics | 881 | MT |
N | 225XF0002X | Feeding, Eating & Swallowing | 881 | MT |
N | 225XG0600X | Occupational Therapist - Gerontology | 881 | MT |
N | 225XH1200X | Occupational Therapist - Hand | 881 | MT |
N | 2251H1300X | Human Factors | 881 | MT |
N | 225XH1300X | Human Factors | 881 | MT |
N | 225XL0004X | Low Vision | 881 | MT |
N | 225XM0800X | Mental Health | 881 | MT |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 881 | MT |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 881 | MT |
N | 225XP0200X | Occupational Therapist - Pediatrics | 881 | MT |
NPI | 1235449240 |
---|---|
Provider Name | Mr. Joseph Lewis Petroni JR. |
First Address | Butte, MT 59701-4022 |
Second Address | Butte, MT 59701-4022 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2010 |
Last Update Date | 05/09/2011 |