Individual
DR. TYSON D DETWILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
4210 MEADOWBROOK LN, WINFIELD, KS 67156-8826
(620) 218-9451
Mailing address
4210 MEADOWBROOK LN, WINFIELD, KS 67156-8826
(620) 218-9451
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01-4983
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
062239
BCBS OF KS PROVIDER #
KS
Enumeration date
10/18/2006
Last updated
01/28/2020
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