Detrick, Domonique M
Detrick, Domonique M is an individual health care provider with primary practice located at 125 E Otterman St , Greensburg PA 15601-2509. She recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as her primary health care specialty. Detrick, Domonique M can be contacted via phone (724) 838-7700.Contact Information
Primary practice address
125 E Otterman St
Greensburg PA 15601-2509
Phone: (724) 838-7700
Fax: (724) 838-7200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | DC007066L | Pennsylvania |
Profile Details
| NPI number | 1801872999 |
|---|---|
| LBN Legal business name | Detrick, Domonique M |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801872999 | NPPES |
| Pennsylvania | MEDICAID | 01664678 |
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