Individual
KERRY E DETWEILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
5024 MAIN RD, HUNTINGTON, VT 05462-9724
(518) 488-8132
Mailing address
5024 MAIN RD, HUNTINGTON, VT 05462-9724
(518) 488-8132
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
074.0131360
VT
2255A2300X
Athletic Trainer
104.0116901
VT
Other
Enumeration date
03/23/2018
Last updated
03/23/2018
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