Individual
NICOLE DITULLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9896 BUSTLETON AVE, PHILADELPHIA, PA 19115-5202
(215) 934-3000
Mailing address
814 MOUNTAIN ST, PHILADELPHIA, PA 19148-1207
(267) 838-8097
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE012823
PA
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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