Corie Detwiler, PA
Physician Assistant, Medical in Tulsa, OK. Individual provider (NPI-1).
NPI number1891032017
StatusActive
Last updated in NPPESDec 7, 2015
Details
- NPI
- 1891032017
- Entity type
- Individual (NPI-1)
- Name
- Ms. Corie Detwiler
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 8, 2013
- Last updated
- Dec 7, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AM0700X | Physician Assistant, Medical | APA2180 | OK | Yes |
Practice location
9716 Riverside PkwyTulsa, OK 74137-7447
Phone 918-528-4897
Mailing address
9716 Riverside PkwyTulsa, OK 74137-7447
Phone 918-299-4333
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