Individual
KEELY R DETWEILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7905 E US HIGHWAY 66, EL RENO, OK 73036-9225
(405) 262-0202
Mailing address
10308 QUEENSBURY DR, YUKON, OK 73099-8277
(405) 373-1842
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/28/2011
Last updated
09/28/2011
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