Individual
MRS. SUSAN DETHMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
CDR
Contact information
Practice address
HWY 56 & 270 JUNCTION, WEWOKA, OK 74884
(405) 257-7318
(405) 257-2696
Mailing address
PO BOX 1475, WEWOKA, OK 74884-1475
(405) 257-7318
(405) 257-2696
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
T202394
TX
Other
Enumeration date
07/20/2005
Last updated
07/08/2007
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