Organization
SPINE INNOVATIONS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD D DIETZE M.D. (OWNER)
(985) 871-4114
Entity
Organization
Contact information
Practice address
29301 N DIXIE RANCH RD, LACOMBE, LA 70445-5403
(985) 871-4114
(985) 871-4130
Mailing address
29301 N DIXIE RANCH RD, LACOMBE, LA 70445-5403
(985) 871-4114
(985) 871-4130
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD.19033
LA
Other
Enumeration date
03/24/2017
Last updated
03/24/2017
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