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Individual

MR. ROBERT CARL DETWYLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
200 PATEWOOD DR STE 100, GREENVILLE, SC 29615-3593
(864) 436-1837
Mailing address
4001 PELHAM RD APT 302, GREER, SC 29650-4352
(727) 501-3291

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AL386
FL
2255A2300X
Athletic Trainer
Primary
AT1042
SC

Other

Enumeration date
05/04/2006
Last updated
05/30/2024
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