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Individual

JEFFREY DEETER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CHA III

Contact information

Practice address
# 8 CHARLES ST., DOT LAKE, AK 99737
(907) 882-2737
Mailing address
# 8 CHARLES ST., DOT LAKE, AK 99737
(907) 882-2737

Taxonomy

Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
11-1125-III
AK

Other

Enumeration date
01/24/2012
Last updated
01/24/2012
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