Individual
MICHELE LYNN DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1804 BRENTWOOD DR, GREENEVILLE, TN 37743-6617
(231) 730-0907
Mailing address
1804 BRENTWOOD DR, GREENEVILLE, TN 37743-6617
(231) 730-0907
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000005109
TN
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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