Most Relevant Information
Provider Data
| NPI Number: | 1003403213 |
| Provider Name: | DEBORAH DALINE DETMAYER |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/22/2020 |
| Last Updated: | 12/22/2020 |
Provider Practice Location
1151 N JEFFERSON ST UNIT 53
MEDINA
OH
442566638
Practice Location Phone/Fax
| Phone: | 2164080977 |
| Fax: |
Provider Mailing Location
1151 N JEFFERSON ST UNIT 53
MEDINA
OH
442566638
Provider Mailing Phone/Fax
| Phone: | 2164080977 |
| Fax: |