Individual
NICHOLAS W DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3101 RECREATION DR STE 130, WASHINGTON, MO 63090-6107
(636) 239-9979
Mailing address
600 OAKMONT LN, STE 600C, WESTMONT, IL 60559-5548
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2020004360
MO
Other
Enumeration date
11/19/2019
Last updated
02/10/2020
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