Individual
SUSAN DATTILO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22051 WILSON RD, GEORGETOWN, DE 19947-3770
(302) 856-3300
Mailing address
22051 WILSON RD, GEORGETOWN, DE 19947-3770
(302) 856-3300
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
L1-004321O
DE
Other
Enumeration date
09/28/2020
Last updated
09/28/2020
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