Individual
PAIGE DETZLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2420 N LEBANON ST, LEBANON, IN 46052-1183
(482) 709-5765
Mailing address
2420 N LEBANON ST, LEBANON, IN 46052-1183
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26027202A
IN
Other
Enumeration date
11/27/2019
Last updated
11/27/2019
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