Edwin Detweiler, ATC, PTA

NPI 1144539685 · on the registry since 2010 · sole proprietor

Practice

Address: 100 Campus Dr
Weatherford, OK 73096
Phone: (864) 616-4448
Organisation at this address: Swosu School Of Pharmacy
Southwestern Oklahoma State University
Southwestern Oklahoma State University
Southwesten Oklahoma State University Training Room
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 24

Registry record

Primary taxonomy: Athletic Trainer
2255A2300X
Also registered as: Physical Therapy Assistant
Licence states on file: OK
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2011-11-22

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma