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Individual

DAVID LEE DUTRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
613 NEW YORK RANCH RD, JACKSON, CA 95642-9328
(209) 223-3030
(209) 223-5864
Mailing address
PO BOX 938, JACKSON, CA 95642-0938
(209) 223-3030
(209) 223-5864

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3190
CA

Other

Enumeration date
09/07/2006
Last updated
11/23/2011
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