Individual
DR. LUCILLE A. DIETRICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
620 CONGRESS PKWY N, ATHENS, TN 37303-1618
(423) 746-4544
(423) 746-4545
Mailing address
620 CONGRESS PKWY N, ATHENS, TN 37303-1618
(423) 746-4544
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1348
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3151639
BCBS
TN
01
—
648850
ACN
TN
Enumeration date
03/06/2007
Last updated
12/18/2008
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