Individual
JENNIFER MARIE DETWEILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3400 E STATE ROAD 28, MUNCIE, IN 47303-9799
(765) 288-5597
Mailing address
1501 E EATON WHEELING PIKE, EATON, IN 47338-8912
(765) 993-3834
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000917A
IN
Other
Enumeration date
08/13/2019
Last updated
08/13/2019
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