Individual
DR. MIKE TODD DIEDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2178 BRIDGER DR, SPRINGVILLE, UT 84663-9469
(801) 422-2145
(406) 422-0555
Mailing address
1500 UNIVERSITY DR, PE 109, BILLINGS, MT 59101-0245
(406) 657-2351
(406) 657-2399
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
6743304-4810
UT
Other
Enumeration date
02/17/2006
Last updated
09/30/2019
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