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Individual
DR. SAM ALLEN DETWILER
Active
Individual
DR. SAM ALLEN DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, ATC
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
94-11926
KS
2255A2300X
Athletic Trainer
AT8023
TX
Other
Enumeration date
03/30/2017
Last updated
06/13/2024
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