Individual
MR. EARL RANDALL SMULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
12 GORDY ST, GEORGETOWN, DE 19947-2116
(302) 854-6677
Mailing address
12 GORDY ST, GEORGETOWN, DE 19947-2116
(302) 854-6677
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
JJ20000757
DE
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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