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1508556028
JOHN DAVID DEETJEN
FORT WORTH, TX
NPI
1508556028
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2023-05-09
Last Update Date
2023-05-09
Business Address
JOHN DAVID DEETJEN PA-C
1201 FAIRMOUNT AVE
FORT WORTH, TX 76104-4215
Phone number: 817-335-5288
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Mailing Address
JOHN DAVID DEETJEN PA-C
6100 HARRIS PKWY STE 285
FORT WORTH, TX 76132-4127
Phone number: 817-263-5864
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