Individual
JACKSON DETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1893 WHISTLING STRAITS DR, ALTOONA, WI 54720-2259
(715) 828-3245
Mailing address
1893 WHISTLING STRAITS DR, ALTOONA, WI 54720-2259
(715) 828-3245
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5425-12
WI
Other
Enumeration date
01/24/2019
Last updated
01/24/2019
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