Individual
MONICA L DIETRICH
Active
Individual
MONICA L DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-02977
KS
225100000X
Physical Therapist
2001010961
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28353043
BCBS KC
—
01
—
KA2868017
MEDICARE PTAN
KS
01
—
MA4370011
MEDICARE PTAN
MO
Enumeration date
05/27/2006
Last updated
01/21/2014
Update your record
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