# DETRICK CHIROPRACTIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841464088
- **Authorized official:** DR. DUSTIN J DETRICK D.C., L.C.P. (OWNER)
- **Authorized official phone:** (937) 420-4000

## Contact information

- **Practice address:** 406 SOUTH MAIN STREET, FORT LORAMIE, OH 45845-0260
- **Practice address phone:** (937) 420-4000
- **Practice address fax:** (937) 420-4001
- **Mailing address:** PO BOX 260, 406 SOUTH MAIN STREET, FORT LORAMIE, OH 45845-0260
- **Mailing address phone:** (937) 420-4000
- **Mailing address fax:** (937) 420-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | 2482 | OH | Yes |

## Other

- **Enumeration date:** 04/18/2008
- **Last updated:** 04/05/2011