Brook Colburn Detrick, LMT, CMLDT
Massage Therapist in Claremore, OK. Individual provider (NPI-1).
NPI number1760104525
StatusActive
Last updated in NPPESSep 16, 2022
Details
- NPI
- 1760104525
- Entity type
- Individual (NPI-1)
- Name
- Brook Colburn Detrick
- Credential
- LMT, CMLDT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 16, 2022
- Certification date
- Sep 16, 2022
- Last updated
- Sep 16, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 157786 | OK | Yes |
Practice location
1501 N Florence AveClaremore, OK 74017-3179
Phone 918-706-1302
Mailing address
417 Scraper StCatoosa, OK 74015-2509
Phone 918-706-1302
Other practice locations
1875 N Highway 66 Ste A
Catoosa, OK 74015-3072
Catoosa, OK 74015-3072
Phone 918-706-1302
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All 6 Massage Therapist providers in Claremore · All 1,633 providers in Claremore
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