Individual
IAN SCOTT DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
526 BROWN ST, PHILADELPHIA, PA 19123-2146
(610) 212-2401
Mailing address
2331 BROWN ST, PHILADELPHIA, PA 19130-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT032896
PA
Other
Enumeration date
01/08/2025
Last updated
01/08/2025
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