Individual
JASON KEITH DETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
5042 MAPLE DR, PLEASANT HILL, IA 50327-2039
(515) 266-4167
Mailing address
1844 17TH ST SE, ALTOONA, IA 50009-2393
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23996
IA
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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