Individual
KENNETH CHARLES DETRING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1014 E JACKSON BLVD, JACKSON, MO 63755-2436
(573) 243-2020
(573) 243-6684
Mailing address
PO BOX 510, JACKSON, MO 63755-0510
(573) 243-2020
(573) 243-6684
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TO2426
MO
Other
Enumeration date
11/16/2005
Last updated
02/28/2008
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