Individual
MARK DIETZGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NMD
Contact information
Practice address
16515 S 40TH ST, SUITE 103, PHOENIX, AZ 85048-0558
(480) 961-0760
(480) 961-0761
Mailing address
16515 S 40TH ST, SUITE 103, PHOENIX, AZ 85048-0558
(480) 961-0760
(480) 961-0761
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
01653
AZ
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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