Provider Demographics
NPI:1548585466
Name:DUTZER, CATHLYN M (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CATHLYN
Middle Name:M
Last Name:DUTZER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 S WOODSIDE LN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-1044
Mailing Address - Country:US
Mailing Address - Phone:757-496-4358
Mailing Address - Fax:
Practice Address - Street 1:312 CONSTITUTION DR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3102
Practice Address - Country:US
Practice Address - Phone:757-497-0764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-03
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202006536183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist