Individual
JAMES JOSEPH DETWILER IBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPTA
Contact information
Practice address
907 N DUPONT BLVD STE 104, MILFORD, DE 19963-1060
(302) 422-2518
Mailing address
507 S WALNUT ST, MILFORD, DE 19963-2329
(302) 258-9676
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
J2-0001279
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
XHD127830688001
—
DE
Enumeration date
10/08/2018
Last updated
10/08/2018
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