Individual
TYLER SCOTT DETWILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3929 E BELL RD, PHOENIX, AZ 85032-2112
(602) 923-5000
Mailing address
29553 N 69TH LN, PEORIA, AZ 85383-3183
(309) 532-3864
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
297985
AZ
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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