Individual
VIRGINIA DETJEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
201 DEERMOUNT ST, KETCHIKAN, AK 99901-6649
(907) 225-7825
(907) 225-1541
Mailing address
201 DEERMOUNT ST, KETCHIKAN, AK 99901-6649
(907) 225-7825
(907) 225-1541
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/25/2007
Last updated
09/25/2007
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