Individual
DR. JOHN A DETTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
114 N AVON AVE, AVON, IN 46123-8475
(317) 272-4100
(317) 272-4110
Mailing address
114 N AVON AVE, AVON, IN 46123-8475
(317) 272-4100
(317) 272-4110
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000607A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932317666
ORGANIZATIONAL NPI
IN
01
—
1942563259
ORGANIZATIONAL NPI
IN
Enumeration date
06/30/2006
Last updated
04/26/2017
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