Individual
JACQUELINE MARIE DETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., ATC
Contact information
Practice address
7400 BAY RD, UNIVERSITY CENTER, MI 48710-0001
(989) 964-7328
(989) 964-7389
Mailing address
7400 BAY RD, UNIVERSITY CENTER, MI 48710-0001
(989) 964-7328
(989) 964-7389
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/05/2007
Last updated
07/08/2007
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