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Individual

DR. WESLEY SCOTT DETRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
3040 S SENECA ST, SUITE #4, WICHITA, KS 67217-3246
(316) 522-6702
(316) 522-7790
Mailing address
3040 S SENECA ST, SUITE #4, WICHITA, KS 67217-3246
(316) 522-6702
(316) 522-7790

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-05112
KS
111N00000X
Chiropractor
2005032885
MO
111N00000X
Chiropractor
3766
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
694221
ACN PROVIDER ID
MO
Enumeration date
12/29/2006
Last updated
06/18/2008
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