Individual
DR. JULIE SUZANNE DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
8231 MAIN ST, KINSMAN, OH 44428-9514
(330) 876-1111
(330) 876-1005
Mailing address
8231 MAIN ST, P.O. BOX 393, KINSMAN, OH 44428-9514
(330) 876-1111
(330) 876-1005
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2992
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000291058
ANTHEM BCBS NPI
OH
05
—
2362250
—
OH
01
—
450511098027
CARESOURCE
OH
Enumeration date
10/12/2005
Last updated
12/04/2007
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