Individual
KELSEY DIETZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2645 COUNTRY CLUB DR, HAMPSTEAD, NC 28443-2530
(920) 428-0370
Mailing address
2645 COUNTRY CLUB DR, HAMPSTEAD, NC 28443-2530
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/22/2017
Last updated
09/22/2017
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