Individual
JACQUELINE BURLETT SUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
100 E LANCASTER AVE STE 230, WYNNEWOOD, PA 19096
(610) 642-3796
(610) 642-2943
Mailing address
100 E LANCASTER AVE STE 230, WYNNEWOOD, PA 19096-3451
(610) 642-3796
(610) 642-3796
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
OT011365
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1025915970002
—
PA
Enumeration date
07/30/2008
Last updated
08/22/2019
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