Individual
KEVIN DEITEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 N MAIN ST, NICHOLASVILLE, KY 40356-2309
(859) 881-8203
Mailing address
901 N MAIN ST, NICHOLASVILLE, KY 40356-2309
(859) 881-8203
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
013367
KY
Other
Enumeration date
09/15/2011
Last updated
09/15/2011
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