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SUSAN L DETTRA LPN

>> Licensed Practical Nurse >> Nursing Service Providers

Registrant NPI Number: 1912195082

Individual Registrant:
 SUSAN L DETTRA LPN
Gender: F
Sole Proprietor

Location and contact information for practice:
54005 SARAHSVILLE RD  PLEASANT CITY, OH 43772-9611 US
Tel: 740-680-7237  Fax: --

Contact information for business:
54005 SARAHSVILLE RD  PLEASANT CITY, OH 43772-9611 US
Tel: 740-680-7237  Fax: --

Registration Information:
NPI: 1912195082
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y164W00000XNursing Service Providers
Licensed Practical Nurse
OHPN078189

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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