Individual
SUPRITHA NAGARAJ POLUBOTHU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1600 ROCKLAND RD, WILMINGTON, DE 19803-3607
(302) 651-4000
(302) 651-4945
Mailing address
PO BOX 191, ROCKLAND, DE 19732-0191
(302) 651-4000
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
J1-0003583
DE
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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