Individual
DR. BRETT ALAN DIETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
114 N GALWAY DR, GRANVILLE, OH 43023-9572
(740) 587-4970
(740) 587-4863
Mailing address
114 N GALWAY DR, GRANVILLE, OH 43023-9572
(740) 587-4970
(740) 587-4863
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5109
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2235414
—
OH
01
—
410046458
MEDICARE RAILROAD BOARD
OH
Enumeration date
09/24/2006
Last updated
12/13/2012
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