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1568026227
GRANT RICHARD DETTEN
ELK CITY, OK
NPI
1568026227
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207X00000X Orthopaedic Surgery
(Licence: OK 6969)
Enumeration Date
2019-04-29
Last Update Date
2024-12-09
Business Address
GRANT RICHARD DETTEN DO
1710 W 3RD ST STE 100
ELK CITY, OK 73644-5160
Phone number: 580-339-7540
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Mailing Address
GRANT RICHARD DETTEN DO
1710 W 3RD ST STE 100
ELK CITY, OK 73644-5160
Phone number: 580-339-7540
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