Individual
JACLYN TARA DELAURETIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
515 JERSEYTOWN RD, MILLVILLE, PA 17846-8825
(570) 458-5597
(570) 458-5114
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-9800
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA057228
PA
363A00000X
Physician Assistant
OA003421
PA
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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