Individual
ERIC WILLIAM DETTWEILER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2001 KIRKWOOD BLVD, SOUTHLAKE, TX 76092-1590
(817) 562-1648
Mailing address
2001 KIRKWOOD BLVD, SOUTHLAKE, TX 76092-1590
(817) 562-1648
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1151540
TX
Other
Enumeration date
07/12/2019
Last updated
07/12/2019
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