Individual
THOMAS M DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9844 S 1300 E, #200, SANDY, UT 84094-4673
(801) 572-1472
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
(801) 572-1472
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
761593551205
VT
Other
Enumeration date
08/18/2006
Last updated
10/01/2007
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