Joshua Ryan Detrick PA-C

NPI 1366603797 - Physician Assistant - 363A00000X

NPI Details
NPI 1366603797
Gender Male
Enumeration Date 06/18/2008
Last Updated 07/06/2015
Entity Type Individual
Active Over 8 years ago
Practice Location
6355 WALKER LANE
STE 202
ALEXANDRIA VA, 22310-3257, US
Phone (703) 810-5210
Fax (703) 810-5418
Business Location
PO BOX 75420
BALTIMORE MD, 21275-5420, US
Phone (703) 383-6469
Fax
Toxanomy
Taxonomy Code 363A00000X
License State North Carolina
License Number 0010-01389
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According to our database, Mr. Joshua Ryan Detrick PA-C NPI is 1366603797, taxonomy code is 363A00000X and license number is 0010-01389, license state is located at North Carolina. Joshua Ryan Detrick PA-C physically located at 6355 Walker Lane, Alexandria VA, 22310-3257. NPI Number Joshua Ryan Detrick PA-C has the Individual type.

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1366603797 NPI number is provided on an as is basis without warranty of any kind. 1366603797 is maintained by the National Plan & Provider Enumeration System. The contents of Joshua Ryan Detrick PA-C are for informational purposes only.