Individual
NICHOLAS BARRY DEETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
165 W COMMERCE DR # 2093, BELLE PLAINE, MN 56011-2911
(952) 777-5661
Mailing address
165 W COMMERCE DR # 2093, BELLE PLAINE, MN 56011-2911
(952) 777-5661
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
68241-21
WI
Other
Enumeration date
04/05/2016
Last updated
07/17/2019
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