Douglas Neil Detten

NPI #1164923009 in Fort Worth, Texas

Provider Information

NPI Number: 1164923009
Entity Type: Individual
Name: Douglas Neil Detten
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Adult Companion
Enumeration Date: Feb 26, 2018
Last Updated: Feb 26, 2018

Practice Location

Address: 8101 BOAT CLUB RD STE 318
City: Fort Worth
State: Texas
ZIP Code: 76179-3633
Phone: (806) 344-0056

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Adult Companion	372600000X	Primary

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