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Individual

DAVID LOOSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
2713 LANCASTER AVE, WILMINGTON, DE 19805-5220
(302) 656-2348
Mailing address
106 GRIER AVE, WILMINGTON, DE 19804-1607
(302) 373-8747

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L2-0008567
DE

Other

Enumeration date
08/21/2015
Last updated
08/21/2015
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