Individual
JEFFREY JOHN DIEPOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
8266 ATLEE RD, SUITE 133PT, MECHANICSVILLE, VA 23116-1804
(804) 569-1665
(804) 569-1628
Mailing address
1115 BOULDERS PKWY, SUITE 200, NORTH CHESTERFIELD, VA 23225-4067
(804) 560-5595
(804) 560-9029
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305205531
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285890988
—
VA
01
—
P00630296
RAILROAD MEDICARE
VA
Enumeration date
08/01/2008
Last updated
06/08/2020
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