Individual
CHARLES M DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
250 MAPLE PLACE, KEYPORT, NJ 07735-1144
(732) 264-8900
(732) 264-0156
Mailing address
250 MAPLE PLACE, KEYPORT, NJ 07735-1144
(732) 264-8900
(732) 264-0156
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
38MC00133800
NJ
Other
Enumeration date
12/06/2006
Last updated
07/08/2007
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