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1023265956
KENNETH JOHN DETRICK
WINSTON SALEM, NC
NPI
1023265956
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: NC 9500884)
Enumeration Date
2008-08-21
Last Update Date
2008-08-21
Business Address
Dr. KENNETH JOHN DETRICK M.D.
190 KIMEL PARK DR
WINSTON SALEM, NC 27103-6946
Phone number: 336-768-3296
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Mailing Address
Dr. KENNETH JOHN DETRICK M.D.
159 KESWICK DR
ADVANCE, NC 27006-7271
Phone number: 336-998-0638
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