Individual
MARTHA DEITRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1000
Mailing address
819 NW DONOVAN RD UNIT 7305, LEES SUMMIT, MO 64086-4580
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/07/2026
Last updated
04/07/2026
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