Individual
THOMAS R. DIETRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9191 GRANT ST., THORNTON, CO 80229-8812
(303) 450-4482
(303) 306-7753
Mailing address
PO BOX 173862, DENVER, CO 80217-3862
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
40451
CO
207P00000X
Emergency Medicine Physician
Primary
DR.0040451
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
98357590
—
CO
Enumeration date
12/02/2005
Last updated
06/25/2015
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