Individual
JESSICA BOND DETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3435 S 4TH AVE LOT 10, YUMA, AZ 85365-4345
(928) 304-1542
Mailing address
3435 S 4TH AVE LOT 10, YUMA, AZ 85365-4345
(928) 304-1542
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
AZ
Other
Enumeration date
10/20/2021
Last updated
10/21/2021
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