Organization
DETRICK CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DUSTIN J DETRICK D.C., L.C.P. (OWNER)
(937) 420-4000
Entity
Organization
Contact information
Practice address
406 SOUTH MAIN STREET, FORT LORAMIE, OH 45845-0260
(937) 420-4000
(937) 420-4001
Mailing address
PO BOX 260, 406 SOUTH MAIN STREET, FORT LORAMIE, OH 45845-0260
(937) 420-4000
(937) 420-4001
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2482
OH
Other
Enumeration date
04/18/2008
Last updated
04/05/2011
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