Individual
SUSAN DETWILER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
2600 E WISCONSIN RD, EDINBURG, TX 78542-6586
(956) 289-2402
(956) 289-2402
Mailing address
1109 S 8TH AVE, EDINBURG, TX 78539-5540
(956) 655-1052
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1887
TX
Other
Enumeration date
01/09/2018
Last updated
01/09/2018
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