Healthcare Provider Details

I. General information

NPI: 1245157767
Provider Name (Legal Business Name): DANA SUTULA PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 MELROSE AVE
WILMINGTON DE
19809-2662
US

IV. Provider business mailing address

1006 MELROSE AVE
WILMINGTON DE
19809-2662
US

V. Phone/Fax

Practice location:
  • Phone: 410-215-4982
  • Fax:
Mailing address:
  • Phone: 410-215-4982
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberJ1-0003261
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: