Provider Demographics
NPI:1588134316
Name:PETRI, JOSIP (OTR/L)
Entity type:Individual
Prefix:
First Name:JOSIP
Middle Name:
Last Name:PETRI
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:JOSIP
Other - Middle Name:
Other - Last Name:PETRI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3107 WESTHILL DR
Mailing Address - Street 2:
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-3774
Mailing Address - Country:US
Mailing Address - Phone:502-777-4899
Mailing Address - Fax:
Practice Address - Street 1:3107 WESTHILL DR
Practice Address - Street 2:
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-3774
Practice Address - Country:US
Practice Address - Phone:715-842-0575
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6845-26225X00000X
IL056.012567225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist