Individual
LIANA DIETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2307 26TH ST, RICE LAKE, WI 54868-9741
(715) 651-0793
Mailing address
2307 26TH ST, RICE LAKE, WI 54868-9741
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
164352-030
WI
Other
Enumeration date
01/30/2009
Last updated
01/30/2009
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