Individual
MR. HAVEN STANLEY CUSTIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT-NPS
Contact information
Practice address
640 S STATE ST, DOVER, DE 19901-3530
(302) 744-6798
(302) 735-3259
Mailing address
640 S STATE ST, DOVER, DE 19901
(302) 744-6798
(302) 735-3259
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
C9-0000166
DE
Other
Enumeration date
01/20/2017
Last updated
01/20/2017
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