Individual
JUSTINE DETROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5187 US ROUTE 60 STE 13, HUNTINGTON, WV 25705-2076
(304) 733-5010
Mailing address
618 RIGHT FORK GEORGES CREEK RD, LOUISA, KY 41230-6726
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2052441
KY
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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