Individual provider · Type 1 NPI
Jackson Detrick
Chiropractor · Altoona, WI
NPI number
1760946743
Active
Practice location
1893 Whistling Straits Dr
Altoona, WI 54720-2259
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 5425-12 (WI) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1760946743
Jackson Detrick's National Provider Identifier is 1760946743, issued on Jan 24, 2019. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Altoona, WI. The record was last updated on Jan 24, 2019.