NPI 1114787082

Jean Marc Ducleron

Practitioner Driver Philadelphia, PA

Practice location

Address: 836 Lawler St, Philadelphia, PA 19116-3436
Phone: (267) 455-1847

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 940627 (PA)

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Registry record

NPI: 1114787082
Entity type: Individual
Sex (as registered): Male
NPI issued: 19 Mar 2024
Record last updated: 19 Mar 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.