Individual
JOANIE MARIE DEATRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2360 E PERSHING BLVD, CHEYENNE, WY 82001-5356
(307) 778-7555
Mailing address
2818 CHERRYSTONE PL, FORT COLLINS, CO 80525-6607
(970) 310-3159
(307) 778-7559
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
0055774
CO
Other
Enumeration date
10/05/2006
Last updated
10/01/2020
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