Provider Demographics
NPI:1235449240
Name:PETRONI, JOSEPH LEWIS JR (MA, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:LEWIS
Last Name:PETRONI
Suffix:JR
Gender:M
Credentials:MA, OTR/L
Other - Prefix:
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Mailing Address - Street 1:2830 HANNIBAL ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-4022
Mailing Address - Country:US
Mailing Address - Phone:406-498-2350
Mailing Address - Fax:406-782-2082
Practice Address - Street 1:2830 HANNIBAL ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-4022
Practice Address - Country:US
Practice Address - Phone:406-498-2350
Practice Address - Fax:406-782-2082
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-13
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT881225X00000X, 225XL0004X, 224ZE0001X, 225XE1200X, 225XF0002X, 225XG0600X, 225XH1200X, 225XH1300X, 225XM0800X, 225XN1300X, 225XP0019X, 225XP0200X, 224ZR0403X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
No224ZE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantEnvironmental Modification
No225XE1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistErgonomics
No225XF0002XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistFeeding, Eating & Swallowing
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XH1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHuman Factors
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No224ZR0403XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantDriving and Community Mobility