Individual
DEREK RYAN DUTTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 N ACADEMY AVE, DANVILLE, PA 17822-0001
(570) 271-6211
Mailing address
833 5TH ST, DANVILLE, PA 17821-7661
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
210151454
PA
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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