Individual
ISAAC DIETERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA, DP-C
Contact information
Practice address
5816 EASTMAN AVE, MIDLAND, MI 48640-6792
(989) 774-1224
Mailing address
5816 EASTMAN AVE, MIDLAND, MI 48640-6792
(989) 774-1224
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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