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1033229935
WILLIAM RUSSELL DETTEN
SPRINGFIELD, MO
NPI
1033229935
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MO R4P90)
Enumeration Date
2006-08-30
Last Update Date
2012-11-12
Business Address
Dr. WILLIAM RUSSELL DETTEN D.O.
1530 E REPUBLIC RD
SPRINGFIELD, MO 65804-6530
Phone number: 417-269-1362
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Mailing Address
Dr. WILLIAM RUSSELL DETTEN D.O.
PO BOX 4046
SPRINGFIELD, MO 65808-4046
Phone number: 417-269-1362
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