NPI 1053605394

Todd Douglas Deetsch

Practitioner Contractor Louisville, KY

Practice location

Address: 208 Linney Ave, Louisville, KY 40243-1014
Phone: (502) 693-1037
Fax: (502) 245-2490

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1053605394
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jun 2011
Record last updated: 3 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.