Individual
MELODY J DETWILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3601 S 6TH AVE BLDG 802, TUCSON, AZ 85723-0001
(529) 792-1450
Mailing address
3601 S 6TH AVE, TUCSON, AZ 85723-8705
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPO44338
AZ
Other
Enumeration date
06/10/2019
Last updated
11/27/2023
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