Individual
GRANT RICHARD DETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1710 W 3RD ST STE 100, ELK CITY, OK 73644-5160
(580) 339-7540
(580) 225-2373
Mailing address
1710 W 3RD ST STE 100, ELK CITY, OK 73644-5160
(580) 339-7540
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6969
OK
Other
Enumeration date
04/29/2019
Last updated
12/09/2024
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